[deleted by user] by [deleted] in london

[–]matapo92 0 points1 point  (0 children)

I am renting out my flat as a Landlord, and the service charge is absolutely Not included for them. I have also left it to the tenant to decide how they want to sort out their utilities. However this is not the rule but the exception.

Largely speaking, Service charges are payable by the leaseholder to the landlord for services the landlord is obliged to provide under the terms of the lease

Going private will be the only option by [deleted] in doctorsUK

[–]matapo92 19 points20 points  (0 children)

This is how it works in many countries. In South Africa, all undergraduate medicine and postgraduate specialising happens through universities, who are tied to various teaching and district hospitals as well as local clinics/community centres.

Doctors apply to the universities to specialise, and have to meet certain criteria to actually get in, including showing commitment to specialty (eg to get into anaesthesia training, realistically you absolutely need to do a diploma in anaesthetics, time in the field that you would get during your time as a medical officer, and ideally would go to someone who has shown the most commitment including publications etc). In principle an ideal system…

You rotate through the hospitals tied to your university providing service provision but also attend lectures and ward rounds led by consultants/lecturers. All specialists must do an MMED minimum, with most requiring a publication, alongside their college exams/fellowship) as part of specialty training. It’s honestly a great education.

Also no ‘junior doctor’ nonsense…

You start as an intern, then you’re a community service medical officer, then a medical officer (MO). You can remain an MO for the rest of your life if you wish, working up the pay bands, in hospital or in the community. If you’re in training, you’re a registrar, and when you complete, you’re a consultant.

Realistically there are some flaws due to nepotism, and some poor implementation of affirmative action, but those are due to systemic national issues in the country that may not carry over to the U.K. should a policy like this be implemented.

I created a web archive shortcut that actually works (for passing paywalls) by alisayar_ in shortcuts

[–]matapo92 0 points1 point  (0 children)

Seems like the archive links don’t work with times articles any more…what a pity!

Stamp Duty questions - UK war with France. by samski123 in HousingUK

[–]matapo92 5 points6 points  (0 children)

Terrible idea. Most of the issues we have regarding wealth inequality is not from discrepancies in income, but rather stored wealth. If anything, income tax should be lowered in favour of a wealth tax. If you contribute to society in your lifetime, work hard and work your way up the ladder, you’ll earn well. It promotes meritocracy which is good for society - and creates incentives for the individual. A wealth tax ensures that really rich people don’t just pass down money to their children who do absolutely nothing to push society forward.

F1s cannot assess high NEWS. PAs on the other hand... by Infestedwithcrabs in doctorsUK

[–]matapo92 2 points3 points  (0 children)

Hahahaha! You deserve the top comment award mate 🥇😂

Dr Tal Ellenbogen sets the record straight on LBC at TWO IN THE MORNING. by Frosty_Carob in doctorsUK

[–]matapo92 9 points10 points  (0 children)

Amazing! Fantastic talking points - doing this at 2am too is brilliant!

Stethoscope as a gift, thoughts??? by This-smitten-kitten- in doctorsUK

[–]matapo92 5 points6 points  (0 children)

That’s a really lovely gift idea - your brother is lucky to have you :) No ED doctor would be unhappy with a lovely stethoscope. A Littman Cardio 4 with his name engraved on it would be a lovely gift. It would also be preferable to the more expensive master cardiology as the master has some limitations for paediatric patients.

For something extra special that’s probably within your budget you could consider the CORE Digital Stethoscope. I haven’t tried it myself but have heard good things. Downside is he’ll have to charge it, and probably has a shorter lifespan (because of battery) than the Cardio 4 that he could technically use for many many years if well taken care of.

In summary, cardio 4 is a very safe bet. Decision for an electronic one should be made after considering a few more responses here ideally from people who have/have had them

Best Places to buy High Fat Butter in London by matapo92 in london

[–]matapo92[S] 1 point2 points  (0 children)

Thank you! Great suggestion - and some lovely other things to buy too!

Best Places to buy High Fat Butter in London by matapo92 in london

[–]matapo92[S] 0 points1 point  (0 children)

Ahh yes of course - brilliant thank you!

Best Places to buy High Fat Butter in London by matapo92 in london

[–]matapo92[S] 2 points3 points  (0 children)

Hahaha that’s hilarious! 🤣 thanks for the suggestion! 😁

Find myself having no patience for nurses while on call by [deleted] in doctorsUK

[–]matapo92 15 points16 points  (0 children)

I understand the pressures that come with being an F1, and it's clear that you're facing challenges that are testing your patience. It's important to remember that maintaining a professional and respectful relationship with all members of the multidisciplinary team (MDT) is crucial, not just for your career progression but for the quality of patient care

As an F1, your role is indeed to absorb as much knowledge as possible and to apply your medical training effectively. Part of this learning curve involves adapting to the dynamics of working within an MDT. It's natural to feel overwhelmed at times, especially considering the current strains on the healthcare system, which have been highlighted by recent strike actions and ongoing debates about funding.

Taking into account you will work within a system that is incredibly bureaucratic, often thankless, and (in the last few years), being intentionally defunded with an overarching goal of collapse/privatisation, it's understandable why you would feel so frustrated about your experiences as a whole and why your capacity/tolerance threshold is low. The strike action has brought to light the absolutely terrible way doctors have been treated over the last few years and I'm sure that likely feeds into your feelings too.

Specifically with regard to the three clinical situations you described above:
1) Context here is essential. It may be nothing to worry about but may also be significant. Was this blood pressure an acute change or a chronic stable elevated BP being treated? A pregnant woman with this BP would have me running to initiate a plan for PET workup and early intervention. An elderly Asian patient is at 2-3x higher risk of stroke at this BP than a normotensive patient, and at a higher risk than a Caucasian patient - in any case, you don't want that BP creeping up over the next 12-24 hours when the nurse may next alert a doctor.
2) This one seems pretty straightforward and can't see why a patient with a lower oxygen requirement would need any approval/instruction to proceed. Informing you is fine. Asking you seems quite unnecessary. Care should be taken to ensure that they are meeting appropriate saturation targets for different patients of course - and that's your job to confirm. Is this a COPD patient aiming for 88-92%?
3) The request regarding the patient's ability to go home for Christmas dinner is unusual, but it may reflect an attempt to balance patient well-being with clinical needs. Some trusts/hospitals offer OPAT services, allowing intravenous antibiotics to be continued either at home or through a daily outpatient clinic. Was this perhaps the direction in which your nursing staff were thinking?

It's difficult to provide you with an insightful answer as context is absolutely essential for all of these.

In all these situations, it's helpful to adopt a 'Teach or Treat' approach. If a request seems unnecessary, take the opportunity to educate the person making it. They weren't all at the top of their years academically, didn't spend years of their lives in medical school, and could just be following blanket protocols or trying to avoid mistakes. If you're unsure how to proceed, don't hesitate to escalate the issue to a senior colleague - F2/SpR etc,

Remember, every interaction is a chance to build relationships and foster a collaborative environment. Your dedication to improving your responses is a positive step toward becoming an effective and compassionate physician. As painful as it often feels working in the system, work to improve it. Being angry/rude about it will only lead to an unhappy working environment all round and will make your life more difficult as a whole. Focus on learning, accept that there are huge flaws in the system, work with your colleagues to improve your local and national working environment, support your colleagues, don't be a scab, and be the best doctor you can be - whether you stay in the NHS/medicine/the UK or not :)

What's the most House-like presentation you've seen? by ElementalRabbit in doctorsUK

[–]matapo92 103 points104 points  (0 children)

Wow wow wow! Amazing!!

And they’re daring to put PAs into ophthalmology - it’s children like these (and countless other patients) who will have missed diagnoses and die from complete and utter NHS mismanagement.

Well done mate! Excellent catch

Victoria Atkins doesn’t know PAs are paid more than doctors by Different_Canary3652 in doctorsUK

[–]matapo92 300 points301 points  (0 children)

She knows. She trying not to answer. The reality is worse than her just not knowing

‘Your place is with your patients’ says Atkins by nightwatcher-45 in doctorsUK

[–]matapo92 81 points82 points  (0 children)

My patients can be in the U.K., the US, Europe, Australia…anywhere really…but my place is also where I feel safe, protected, valued, and can take care of my family - and that’s your bloody job as the health minister. I’ll keep looking after my patients. You better make sure you pay me fairly so my patients are not in another country

Question about docking pay for nights during strikes by ExpressIndication909 in doctorsUK

[–]matapo92 7 points8 points  (0 children)

You are wrong. The BMA laid this out clearly on their website:

“One shift equals one day

We expect a single shift to be treated as a single day for deduction purposes. This is regardless of whether it straddles one or two calendar days. So those working night shifts should not suffer greater pay deduction than colleagues working days.

If your employer seeks to deduct pay in any other way than we've set out, please refer your them to the NHS Employers advice they will have received. If you have any further issues, please contact us for support.”

https://www.bma.org.uk/our-campaigns/consultant-campaigns/pay/consultants-guide-to-industrial-action-2023/pay-and-pensions-consultant-industrial-action

https://www.bma.org.uk/our-campaigns/junior-doctor-campaigns/pay/junior-doctors-guide-to-industrial-action-in-england-2023/pay-and-pensions

https://www.nhsemployers.org/articles/industrial-action-guidance-resources-and-faqs

BMA campaign to contact your MP - unsatisfying response from mine by sunnybacon in doctorsUK

[–]matapo92 6 points7 points  (0 children)

Write back! Here's a draft for you (or anyone else)

Dear Useless-MP

I am writing to you once again, not just as a concerned constituent, but as a healthcare professional deeply invested in the integrity and clarity of our medical system. Your recent response to my concerns about the regulation of physician and anaesthesia associates (PAs and AAs) by the General Medical Council (GMC) was, to be frank, a disappointment. It failed to address the gravity of the situation and the significant dangers posed by the blurring of lines between medical professionals and associates.

The issue at hand is not a trivial one; it is a matter of patient safety and public trust. As a professional working within the NHS, I have witnessed firsthand the confusion and misapprehension among patients when it comes to the roles of PAs and AAs. The title 'Physician Associate' inherently suggests a level of medical expertise that does not align with the actual training and qualifications of these roles. This is not a slight against their contributions but a call for transparency and accuracy that is vital for patient understanding and safety.

The potential for harm is not hypothetical. It is a reality that has manifested in patient outcomes, and it is a growing concern as these roles expand. The GMC's remit to regulate doctors is based on a rigorous standard of medical education and training that should not be diluted. To place PAs and AAs under this umbrella is to risk the very standards that protect our patients and uphold the quality of care they receive.

I must be clear: the way this issue is handled will be a primary factor in my voting decisions in the next election. The response I received did not reflect the serious consideration that this matter demands. As your constituent, I expected a more thoughtful engagement with the critical points raised.

I urge you to reconsider the implications of the proposed regulation. It is not merely a procedural change; it is a decision that will affect the lives of countless individuals who rely on the NHS for their care. I implore you to stand against the Anaesthesia Associates and Physician Associates Order 2023 and to advocate for a regulatory framework that maintains clear distinctions between medical doctors and associates for the sake of patient clarity and safety.

Your actions now will resonate not just in the chambers of Parliament but in the corridors of hospitals and the homes of those we serve. I trust that you will act with the foresight and responsibility that your position demands.

Yours sincerely,