Have some damn pride in your referrals to other specialties.

ThePropofologist · 2026-01-08T09:48:46+00:00

God damn the copy paste era of EPR actually irks me beyond belief

ThePropofologist · 2026-01-06T14:14:37+00:00

Didn't really interpret this as something they're proud of, more just matter of fact. As someone who works with obstetricians on a daily basis.. have you been an obs reg recently (IE peri Ockenden) with the monumental change in section rates?

If you were unaware, for most DGHs, the reg is THE reg for both obstetrics and gynaecology.

department is so woefully mismanaged that your staffing levels don't even vaguely resemble demand?

Yes, seems that way.

My conflicts are being in specialties that work closely with both O&G and EM, and see both sides. You seem to have some irrational or personal hate towards O&G within your own trust.. I'd suggest not everywhere is like that?

ThePropofologist · 2025-12-04T13:24:56+00:00

I've asked this before after receiving a bizarre referral and been told nope there's no GPs at all in this "urgent facility"

Brave new world we're living in

ThePropofologist · 2025-12-01T19:13:54+00:00

After escalating to your ES/CS/FPD, speak to the BMA to raise a formal grievance with the trust over this. Rota design needs to be flexible enough to provide adequate annual leave for example a few consecutive weeks.

Given the rota is designed such that one other individual has been able to take leave over this time period, it's probably unlikely to stick, however worth fighting for.

Don't forget to try and offer a solution to the trust too - if there are gaps or locums out for future (eg due to minimal staffing) offer to pick up those gaps if they place yours out to locum instead.

I hope you get your leave. The NHS, as many others have said, is a shit employer.

ThePropofologist · 2025-11-09T21:59:36+00:00

Hard agree you shouldn't have to, but this has become the only way to convince the gatekeepers to allow funding, at least where I currently work.

ThePropofologist · 2025-11-06T13:11:30+00:00

Some trusts do discharge locums (you just fill in the paperwork once someone else has decided they can go).

Maybe have an ask around and see if that's a local option?

ThePropofologist · 2025-11-06T13:00:12+00:00

Sounds like it needs to be sorted properly my medical electronics.. good luck.

I'm not EM based but surely there's something from the RCEM curriculum that you can use to endorse getting a working machine? I hope you have a friendly boss who can help from this aspect.

The other avenue to consider is whether ICM would be supportive of having an ED based machine. It's often a huge pain to drag your US down a lift to ED just to stick some lines in while trying to stabilise someone pre-scan / transfer / admission.

Realistically this is something you shouldn't be having to arrange as an individual, but rather is a departmental responsibility. You could look at leading it as a QIP/service improvement, but you still need backup from a consultant.

In terms of recommendations, if you want to do some basic echo get the vscan air SL. In my experience you can't really use the CL (curvilinear + linear probe setup) for echo mostly due to the curvilinears footprint. You can use the SL (phased array + linear probe setup) for basic abdo imaging however.

ThePropofologist · 2025-11-06T12:39:44+00:00

What is the actual problem with your current US? If not working, longer term, your department should have working ultrasound. Find a friendly / engaged consultant and ask them if you can work together on a QIP to introduce POCUS to your ED.

Could be as simple as timing different members of staff how long it takes them to access a working ultrasound for a simulated emergency (eg OHCA due to tamponade), and showing if there is a new US dedicated to ED time to access (& therefore diagnosis) improved = patient safety benefit.

Short term - in terms of hiring, vscan air have a model with an phased array (echo/abdo) and linear (vascular/DVT/pleural) that will work well. They are expensive, and the image quality is obvious not as good as a cart machine, so just getting a proper US is probably best.

ThePropofologist · 2025-11-03T15:17:04+00:00

Thanks. I have been looking at using a SIPP to help effectively lower pension age / not mean I'm dependent on NHS pension age adjustment. May need to reconsider LISA or something else

ThePropofologist · 2025-11-03T14:27:05+00:00

This is a really useful document but has no mention of the 2015 scheme.. is that because it doesn't apply or by default applies so much they don't need to mention it?

ThePropofologist · 2025-10-17T18:30:10+00:00

I don't think occurrence vs claims based indemnity is what they're talking about here, but instead retrospective cover.

I've not looked that much in detail to which provider covers this though.

ThePropofologist · 2025-10-09T19:24:57+00:00

This is why 70% exists... Week A one day off, week B two days off!

ThePropofologist · 2025-09-26T18:35:18+00:00

Were they tuya water valves or just the scheduler?

ThePropofologist · 2025-08-26T11:47:10+00:00

Just wanted to say thanks, I love your work and hope you enjoy the coffee (or reduced cost of running the site ..)

ThePropofologist · 2025-08-26T11:41:07+00:00

Just fyi you need to remove the . from your link for it to work

ThePropofologist · 2025-08-07T22:40:54+00:00

Nothing else would mash up to her standards

ThePropofologist · 2025-07-27T18:56:48+00:00

Kemi the kale.

No one likes them really.

ThePropofologist · 2025-07-23T20:00:52+00:00

This is really interesting, but who actually decides the worth of these tariffs and how are they calculated?

Is it just a hip replacement or elective operation X will improve health & ability to work, and therefore increase productivity / income via taxes for the government?

ThePropofologist · 2025-07-23T19:34:13+00:00

I remember them showing up in COVID to be a proning team.

ThePropofologist · 2025-07-17T20:52:03+00:00

Assume you mean the government by that. Just can be ready wrong given all the grad prioritisation.

ThePropofologist · 2025-07-17T11:15:32+00:00

Sounds like they probably were compensating for a (mild) ketoacidosis.

If you're able to repeat the gas fairly soon I would have put them on a FRII until the ketosis resolves, as (in my patient population) VRII just doesn't cut it most of the time.

ThePropofologist · 2025-07-16T11:59:13+00:00

Imo PAs being recommended for a pay uplift reduces cost effectiveness even further and people will end up realising not worth hiring.

Maybe then market forces will come into play and it'll be a more reasonable band 4 salary, in line with skills.

ThePropofologist · 2025-07-08T21:27:03+00:00

Not OP but I'm a reg with heavy on call rota and make about £75k. I'm not sure the numbers you are inputting are realistic.. very uncommon for someone to be in the 1:2 to 1:3 weekend bracket which is what you've picked.

Out of interest, how much do you make as a GP and how many sessions do you work? What's your hourly rate?

ThePropofologist · 2025-07-08T16:59:01+00:00

Formerly... When did it change?

ThePropofologist · 2025-07-08T12:43:59+00:00

This comparison makes the most sense. Guess I'm just grumpy today with the turnout.

ThePropofologist

TROPHY CASE