Expanding on this & personal reflection.... These are my MRI STIR images (sagittal) - shows bilateral L5 nerve root oedema secondary to stenosis / compression I have deep seated superolateral gluteal pain & tenderness ++ on palpation into 'piriformis' both sides - including

Surgeons in training - be aware of context switching, attention residue and decision fatigue. Below is a near miss of mine I don't want you to repeat. #neurosurgery #training

https://t.co/395cEHbb94

The Government can’t keep expecting general practice to provide timely, safe care for patients if we simply don’t have the means to do so. That’s why our Chair, Professor Kamila Hawthorne, is asking you to join her in signing a letter to Wes Streeting, calling on him to make

Paradoxically, it’s both. We’re circa 40,000 doctors short of European average for our population; and the consequences of that are evident with >7m people on waiting lists. And Government is failing to employ the doctors we do have. Catastrophically poor workforce planning.

How accurate did we find POCUS to be for detecting paediatric appendicitis? We undertook a multicentre study: https://t.co/eJHqXgVZF7 @salmannaeem217 @POCUS_Toronto @kyliebaker888 @POCUSJournal

Consent ✅ Super active 50 year old THR 1 year ago Disabling groin / anterior hip pain - gradients, stairs, putting trousers on Positive FADIR test Weak & painful ++ on resisted hip flexion & SLR Xray and CT unremarkable MRI - interpretation compromised by metal artefact

Consent✅ Rugby player Unusual cause of posteromedial knee pain Discomfort & 'flicking' sensation under dynamic single leg load, especially explosive cutting / change of direction Referred as pes anserine inflammation - not far 'off the mark' clinically POCUS - active knee

This is a fixable problem, but we aren't making the right calls. We're also spending a lot of effort on initiatives that are poorly thought out, never proprely evaluated and create supply induced demand. A thread of my rambling thoughts.

7. If we add people waiting 12+ hours in EDs onto occupancy statistics, it shows hospital occupancy rates over 100%. The same happens if we include stays over 24 hours. Not all of these patients are admitted, some just go despite illness, or some get better

This should be taught in mass casualty courses

Corridor “care” is degrading but waiting room care episodes are on a whole different level. We’ve heard of 24 hours in waiting room being the norm and when pressured people appending first 3 days there. @acutemedicine https://t.co/6iPvqTZH1V

Facts vs Fiction : GP Partners earnings Information shared publicly on GP income is based on Tax returns which includes all income sources not just NHS High earning GPs are the exception the median is the real income PM earnings 2023/24 just 1.5% of GPs earn the same as the PM

Interesting trends starting to emerge. In Emergency Care why does winter feel like it has come early? Because it has - Flu earlier than normal. Get vaccinated if you are eligible. #flu https://t.co/GozIZWxzen

Reason number 78987 why #pocus is important: The admitting diagnosis is not always right. This was a young patient who presented with syncope. She had just overcome a GI illness with diarrhea and vomiting and presented to the emergency department. She was tachycardic and

How can we find breast cancer early if people are waiting 10 weeks for a tissue diagnosis and then further months for surgery, chemo and radiotherapy? My practice had our mammograms in August. None of the patients with abnormalities have started treatment yet. @mikenesbittni

https://t.co/NRekKLrC2I My team did this interesting systematic review. We aimed to identify whether different types of ingested foreign bodies had different consequences and whether there were very low risk cases that can be discharged quickly. 1/n 🧵

We have a problem @wesstreeting @SKinnock It’s a capacity problem there aren’t enough GPs to meet patient needs Decided unilaterally to make GPs deal with more online requests This will increase workload& mean access for the most vulnerable is reduced Well done 👏🏼 FUND MORE GPs

PSA screening media coverage is currently very poor. Various charities are not helping but instead adding to the confusion and hype. The Times today carries another high profile individual story of how they were "absolutely" saved by screening with PSA testing.