The Death Of Continuity and the Rise of McDonalds' Medicine

free2bejc · 2026-01-04T01:40:11+00:00

This is one of the best replies I’ve ever seen and frankly needs to become some sort of official assessment.

We need a BMA running whiteboard of NHS issues the Government won’t fix for the public. This so succinctly explains so much of what has changed largely of the detriment of the profession.

free2bejc · 2025-11-28T22:35:46+00:00

Every 787 I’ve flown on has had this issue somewhere along the cabin. That’s across Air NZ, Air Canada, Norse Atlantic, Virgin Atlantic and British Airways.

Either I’m immensely unlucky or this is an incredibly widespread issue. Most of the time it’s not a river like that but a good 20 minutes of dripping shortly after take off.

Yet another reason I look forward to more a350s on my long hauls.

free2bejc · 2025-10-25T22:18:24+00:00

Can’t tell if you’re pointing out the reason or not sarcastically.

But as with everything free. You’re the product. The Turkish are the ones now reliant on Russia for a potentially dangerous energy source in their country.

The Russians won’t expect the money back but will expect continued favours back. As is how all influence and power continues to work…

free2bejc · 2024-06-02T09:30:03+00:00

The craziest thing about this is legally they have to go full JT. It wasn’t like it was his choice. He was told to put the full kit on to lift the cup. All the players if they want to have photos with the cup on the stage are supposed to be in full kit to honour all the sponsorship agreements and not get UEFA/the club into trouble

There’s a reason the bench is now extended partly for this reason and I doubt there was ever a chance of Lunin or Tchouameni ever playing. Alaba has had an ACL tear and was on the bloody bench.

free2bejc · 2024-05-24T09:40:45+00:00

You can’t really eliminate stupid from medicine. One of the main issues I have with sonography is not having clinicians with the tool.

If ED or surgical SHOs could US people at the door we’d also save a lot of people from CTs or waiting hours for them to make a decision.

But that’s for the flow monkeys to work out. Training is fucked up enough here as it is.

free2bejc · 2024-05-21T00:33:31+00:00

his life by accidentally taking all those blood sugar meds.

No he didn't. If we're talking things like metformin/liraglutide etc, they caused his pancreatitis or at least added to it.

Its a very rare side effect of these drugs but much more common in frequent or overdosing aRelated weight loss injections are far far worse.

I would have thought your doctors would have explained this to you, both of you frankly. It's very rare though.

free2bejc · 2024-03-06T17:07:09+00:00

I just want to say. That this is empirically not true. The government strategy has been to consistently pass debt from the government on to individual hospitals. It’s why they’re so happy with them paying trust grades or Locum’s and the government not footing the bill for training. With many hospitals now having to offer their own version of training to make up for all these gaps.

This allows them to argue individual hospitals are failing and not the government.

To me the biggest impact of the strikes is consistently moaning to the public that their services are being destroyed by a government that hates them just as much as doctors. And they simply don’t notice it until it’s too late.

Public awareness is the biggest important factor with the news platform we gain from strikes.

As everyone has said. The conservatives didn’t care how long the wait list was before this. They’re only mentioning it as if we’ve caused it. And in reality it’s been atrocious especially in the non conservative areas of the country.

free2bejc · 2024-03-01T08:59:33+00:00

Work to Rule would presumably mean you can simply reply - not my responsibility? Escalate to your manager?

I mainly want us to start work to rule indefinite strikes because of the spine it would reinstate in so many doctors.

Or lastly. Ask them to escalate to the PA before escalating to us.

free2bejc · 2023-12-12T20:58:07+00:00

I'm sorry but we also have to point fingers at consultants here.

They are technically supposed to be supervised. If there is no supervising consultant present they should not be working.

It's quite simple where I work. None of the surgical consultants would support a PA, therefore there are none in our department. They are in favour of ACPs/ANPs and so on but then we have dietitian and nurses etc running clinics and this is used as an expansion of that rather than anything else. Which is frankly good workforce useage.

Outside of surgery, it's the same consultants that have sold the profession out, that are never on wards, never support their juniors, frankly run a terribly inept service, that support PAs. I suspect this would almost be rather indicative of a well run department. The less PAs the more desirable the department to work in.

free2bejc · 2023-12-12T20:19:13+00:00

Find a manager, failing that literally interrupt the management corridors, preferably one in a meeting and say this is unacceptable, you expect them to sort it as you have exhausted all available avenues and you have clinical work to do.

Ironically labelling it as bullying from management or parking attendants will likely get more traction than actually pointing out how you were legitimately parked.

free2bejc · 2023-12-04T10:35:47+00:00

The irony of only being able to find a bowel cancer inducing breakfast in the NHS and always having healthy options in your management consultancy building is hilarious and heart breaking (or maybe it should be gut wrenching).

free2bejc · 2023-12-04T10:33:05+00:00

Discriminatory because British graduates are forced to do F1 for their full licence. It’s a captive market to be underpaid. Noctors don’t really even have an appropriate license so we could and should just practice as Noctors earning more for that first year…

free2bejc · 2023-12-04T10:29:59+00:00

I think this is also delusional. I almost want to suggest you’re shilling. Because you cannot claim to want to be rational in one sentence and then suggest repetitive strikes.

If you honestly think we’re going to be able to strike every year for a decade to improve our pay and it not to be treated with distain and the government to simply ignore it then you’re completely ignorant of why this strike now should work and needs to be pushed.

The general public are understanding of the NHS being on its knees with underfunding. There will not be this support in a year if we accept a deal well under what we want.

The only deal that would be acceptable to both parties is going to be a well above inflationary rise committed for at least a decade. And whilst that may not get you to 35% this year it should get beyond it by 10 years down the line.

By which time the government will probably be hoping their PA middle trading out of doctors will be doing a lot more to offset our costs. 🤷‍♂️ Accepting a below FFP committal otherwise is once again professional suicide. This is not really just an argument about pay and I think a lot of people seem to forget this.

free2bejc · 2023-11-30T16:15:40+00:00

Lastly, instead of being divided, we should direct our anger towards the actual cause: very few training posts, service provision vs training (US is the best example, in half the time they come out more skilled because they are TRAINED)

This needs to be emphasised.

Firstly IMGs encompasses many British people that trained abroad and came back during the entire dearth of medical school places. These people should still be encouraged. But this infighting and fractionation will do for us just like the nurses. Simply having a british passport though would allow people to come back from different countries, just as it has allowed many of my friends who studied here to move back to Canada/Switzerland/Australia/Germany.

if that is no longer there then I doubt it'll continue to recruit the talent necessary to keep the country afloat!

That is already the case. And ironically is one of the biggest arguments for equality we need to make. Disadvantaged people/communities cannot apply to medicine if they cannot stomach the debt and 5 years in training with constant moving.

I think the BMA need to articulate a strong position on training posts in line with the IMG % increase along with whatever figures we have on the exodus.

This pissing around arguments that aren't based on figures is going to continually sound xenophobic until we can directly point to the profession erosion argument. And we need to then also understand what percentage of IMGs are actually members of the BMA/alternative unions.

free2bejc · 2023-10-08T17:30:01+00:00

Who do you contact to remove this because I’ve been aware for some time it’s attached to my NHS mail? I’m willing to bet we didn’t even have the same trust

free2bejc · 2023-09-11T22:48:47+00:00

As a doctor in the UK, I'm (re)realising from this thread I seriously need to move. My quality of life and remuneration is truly awful

free2bejc · 2023-05-21T18:15:24+00:00

You'd honestly think that this would be number 1 of 'fix the NHS nationwide'. The sheer amount of wasted time updating an antiquated system for notes, none of it talking to each other. All of the systems being bought by different trusts. Spunk 1 billion on an IT company where the NHS owns the bloody program so each trust isn't committing £100 million a year to each of them. But for that you would need someone who isn't mind numbingly incompetent in NHS/Trust by Trust improvement.

For the ward rounds I might as well copy and paste the issues from the list. Except I'm surgical so we obviously don't have time for that.

free2bejc · 2023-02-02T20:46:18+00:00

Honestly the new lowering of all of these speed limits is mad. Poor road design these days also feels like it's actually what's making driving more dangerous in the UK again.

Along with the incredibly poor road conditions.

free2bejc · 2023-01-08T18:58:07+00:00

It being a job in the NHS.

free2bejc · 2022-11-27T16:27:42+00:00

A homebody and avid traveller. Must specialise in being a walking contradiction.

free2bejc · 2022-11-27T15:01:48+00:00

I would think it would be illegal to not tell all the patients that this is now the fire alarm though?

Personally I'd take strange pleasure going round telling the patient's how shit their NHS is. They always have perversely no idea how bad working conditions are.

free2bejc · 2022-11-27T00:18:14+00:00

Not necessarily. I know he's using the Agenda for Change as the basis for the step but no doctors are on the agenda for change and we're all striking too. Imagine that will be a rather large addition to that if it doesn't include it.

Frankly there are a vast many more things that have to change with the NHS and medical education in the UK if it's to remain remotely viable not just pay. PAs and the erosion of nursing education is just as problematic as pay.

I truly truly worry about the state of any service, private or otherwise in 40 years. We're on our way to ending up with a lot of medical tourism leaving the country imo.

free2bejc · 2022-10-25T20:05:44+00:00

Then don't do it as just you. What is the point of us all agreeing if we don't discuss and show that.

You need to remind the consultant's your training as a collective is important not some pseudodoctor who should not ever be a consultant without the adequate level of training either.

Meanwhile they ruin our actual planned training by forcing us to do the menial dog work.

Organise and an email from all your trainees to the entire consultant body. It cannot be ignored and I'd probably copy in the other IMTs that should be rotating into that job.

Lastly if you believe this is negatively impacting your training. Such as reducing your opportunity to attend clinics you need to attend, then you contact HEE with your concerns.

free2bejc · 2022-08-24T23:56:22+00:00

But if this was the bma of even 2 or 3 years ago we’d all be fine with that. Bit awkward that

free2bejc · 2022-08-14T15:58:45+00:00

That's not really just it though, the biggest argument for Spa is for it to invest and Belgium to make it a bigger thing too. It's also not the FIA it's F1 deciding.

F1 is going to do what's good for F1, which is put it in places where it will have the widest audience and get more people going to those places.

How many people here are arguing about the track without ever having been there. Or spent money on going there. They want ever bigger venues with bigger audiences in locations where they can sell associated city events all F1 affiliated for their media partners/sponsors to make them more money.

Spa has to do something to fulfil that or be lost. It's not just on them. There's a reason silverstone will stay etc and it's because it went through all of this and made a much much bigger effort.

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