Volume 2 Issue 2 - 2006
‘Modernising Medical Careers’, otherwise known as ‘MMC’, is the umbrella under which all junior doctors’ training is currently being reorganised nationally. The government has been open about it’s commitment to primary care, which it sees as the cornerstone of the future NHS. Clinical work continues to be shifted from secondary to primary care, and with the numbers of Hospital Speciality training posts set to decline, we are led to believe that General Practice training posts will be maintained. Mr Martin Dennis, Consultant Vascular Surgeon at Leicester Royal Infirmary, makes reference to the increasing sub-specialisation of hospital consultants in his article (page 55), and the opportunities that could arise from this for primary care practitioners. He gives a good argument for the development of more GPwSIs in vascular disease, not only in dealing with coronary heart disease, stroke and hypertension which contribute a large proportion of any practice’s QOF points, but also with peripheral vascular disease, aortic aneurysm screening, carotid artery scanning and varicose vein management. This sounds an interesting area to be explored and developed by GPs and local commissioning groups.
Dizziness is a common problem in general practice, where a GP with an average list size can expect to see about 25 patients a year with this as the presenting symptom. About 10% of patients attending a hospital or GPwSI ENT clinic will present with dizziness and 30% of over 65 year olds will report it. The diagnosis and management of dizziness can cause problems for the clinician.
Immunology and autoimmune testing have the reputation for being complex and difficult to understand. However most of the tests in current practice are relatively straightforward and in this article I try and dispel some of the myths, and attempt to clarify the interpretation of the more common autoantibody tests used in clinical immunology.