Fat Bastard
This has been debated at length previously.
At one time, a raised BMI resulted in just a raised eyebrow from the AME.
Now, I believe they get twitched if the BMI>38.
PS I'm not sure if the phrase fat b*stard is allowed on here. The term pie eater is favoured.
At one time, a raised BMI resulted in just a raised eyebrow from the AME.
Now, I believe they get twitched if the BMI>38.
PS I'm not sure if the phrase fat b*stard is allowed on here. The term pie eater is favoured.
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Jeez, 10 years ago I encountered an AME who was employed by British Midland as was (don't know if he still is there or retired...) who denyed me a sponsorship as I was just on the wrong side of BMI 30. Just depends on who you get I guess.
BTW if you are that Doc and you're reading this - I'm still doing fine 10 years later. Thanks Doc C
BTW if you are that Doc and you're reading this - I'm still doing fine 10 years later. Thanks Doc C
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In most cases it depends how many pies your AME eats. And for that matter how many fags they smoke also. Just need to get Gingernut on 20 a day and he would be perfect 
The healthy AME's give you loads of advice on health matters some see it as thier duty to give you a well man clinc as well seeing as you have your trousers down. They also have a supply of boxes for you to crap in to see if you have colon cancer.
The pie eating, fag smoking AME's don't seem to say much on the subject.
PS I go to a super fit AME who gives me a good talking to every time and he justifiably proud of the number of cancers he has caught well before normal, with the pilot returning to work after its sorted.
The healthy AME's give you loads of advice on health matters some see it as thier duty to give you a well man clinc as well seeing as you have your trousers down. They also have a supply of boxes for you to crap in to see if you have colon cancer.
The pie eating, fag smoking AME's don't seem to say much on the subject.
PS I go to a super fit AME who gives me a good talking to every time and he justifiably proud of the number of cancers he has caught well before normal, with the pilot returning to work after its sorted.
Okay, okay, I've put my head above the parapet in the pie eating JB thread.
But it does have to be said that the relationship between AME & Pilot, rarely seems confrontational, from what I read on here.
So, if the fat twa* says lose weight, its likely to be because he cares for your health, and career, rather than anything else.
But it does have to be said that the relationship between AME & Pilot, rarely seems confrontational, from what I read on here.
So, if the fat twa* says lose weight, its likely to be because he cares for your health, and career, rather than anything else.
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Yep and its proberly because we get to sit with them for an hour every year.
The old farts it used to be every 6 months.
And the relationship between myself and my AME is completley different to the one I have with my GP.
For one I can phone and I get put through to him without the witch on the front desk hinting to bugger off. And if he really isn't available he rings me back.
And I have no doudt that I get the standard of care that he wishes he could give to every person that walks in through the door. But as he says apart from the pilots he doesn't often gets to speak/examine healthy blokes.
The old farts it used to be every 6 months.
And the relationship between myself and my AME is completley different to the one I have with my GP.
For one I can phone and I get put through to him without the witch on the front desk hinting to bugger off. And if he really isn't available he rings me back.
And I have no doudt that I get the standard of care that he wishes he could give to every person that walks in through the door. But as he says apart from the pilots he doesn't often gets to speak/examine healthy blokes.
To set the record straight, I'm not a doctor.
And I'm not sure it's up to me to defend GP's, but having worked with many over the years, I can honestly say, I havn't met one yet who isn't interested in improving the quality of care they give to their patients.
Access, is, of course, a major issue. The reason is quite simple- there are x amount of appointments required each year, and there are y number of doctors offering appointments every z minutes.
Now I 'aint no mathematician, but I guess the simple solution would to be to try and fiddle with x,y or z. (We've tried this with various amounts of success.)
Controlling x is difficult-there have been various schemes (NHS direct, Walk in Centres etc), which have offered alternatives to the traditional GP model, with varying degrees of success.
Increasing y is also problematic-unfortunately, the numbers arn't coming up through the ranks- resulting with us having to recruit from elsewhere- with varying levels of success.
We tried experimenting with z - again varying levels of success- I've seen allocations of less than 5 minutes per consultation- it improves access, but does it result in a satisfactory outcome- probably not. (And it tends to burn people out).
Of course, the smart guys employ more of these....
who seem to be able to deliver care safely and effectively. (I'm the one in the middle).
As for examining healthy blokes?? In the big scheme of things, it probably doesn't make that much difference to health outcomes. We have to be careful that we don't increase x, with no added benefit to your health. We have to concentrate on what we know works.
Remember, your AME is coming from a different perspective, he's payed to try and predict which pilots could drop dead at the stick and rudder-how effective that process is, is another argument.
I know from previous debates on here, aviation medicals have picked up problems for individual pilots- and perhaps we need to capture something of why that process happened-but again, we have to concentrate on what we know works.
Cheers, and good health, ginge
And I'm not sure it's up to me to defend GP's, but having worked with many over the years, I can honestly say, I havn't met one yet who isn't interested in improving the quality of care they give to their patients.
Access, is, of course, a major issue. The reason is quite simple- there are x amount of appointments required each year, and there are y number of doctors offering appointments every z minutes.
Now I 'aint no mathematician, but I guess the simple solution would to be to try and fiddle with x,y or z. (We've tried this with various amounts of success.)
Controlling x is difficult-there have been various schemes (NHS direct, Walk in Centres etc), which have offered alternatives to the traditional GP model, with varying degrees of success.
Increasing y is also problematic-unfortunately, the numbers arn't coming up through the ranks- resulting with us having to recruit from elsewhere- with varying levels of success.
We tried experimenting with z - again varying levels of success- I've seen allocations of less than 5 minutes per consultation- it improves access, but does it result in a satisfactory outcome- probably not. (And it tends to burn people out).
Of course, the smart guys employ more of these....
who seem to be able to deliver care safely and effectively. (I'm the one in the middle).
As for examining healthy blokes?? In the big scheme of things, it probably doesn't make that much difference to health outcomes. We have to be careful that we don't increase x, with no added benefit to your health. We have to concentrate on what we know works.
Remember, your AME is coming from a different perspective, he's payed to try and predict which pilots could drop dead at the stick and rudder-how effective that process is, is another argument.
I know from previous debates on here, aviation medicals have picked up problems for individual pilots- and perhaps we need to capture something of why that process happened-but again, we have to concentrate on what we know works.
Cheers, and good health, ginge
Last edited by gingernut; 15th Jan 2009 at 08:23.
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Personally I think you should add w into the equation.
The w is for a suitably qualified nurse who can prescribe for basic complaints.
They would be open 6am until 10pm, if you decided you couldn't be bothered with said nurse you could go straight to the GP but it would cost you 50 quid.
If the nurse then refered you to the GP it would be free.
PS I had to do a double take at that photo tuck your belt in
The w is for a suitably qualified nurse who can prescribe for basic complaints.
They would be open 6am until 10pm, if you decided you couldn't be bothered with said nurse you could go straight to the GP but it would cost you 50 quid.
If the nurse then refered you to the GP it would be free.
PS I had to do a double take at that photo tuck your belt in
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Not a GP myself, but I'm pretty sure that most GP's would enjoy being able to spend upto an hour with each of their patients. It would probably mean less work for a start!
The way GPs work is defined almost entirely from without i.e. They're told when to work, who to work with, who they see, when they see them, how long they spend with them, what they say to them, how they say it and what they prescribe. Oh, and who to refer to, when to refer, and how, and what to refer for.
It comes from government either via the PCT, or more directly via the contract they have with govt, which a lot of GP's said at the time would make them more money (sic.) but would affect the care they provide (e.g. you go to your quack with a cough. You get your BP done. tick. Diabetes check. tick. Well man screen. tick tick tick. Off you go with your GP having fulfilled his contract requirements, but you still have a cough!)
Sounds a bit restrictive, maybe?
As far as I can tell, AME's have to prove they're suitably qualified to be AME's, abide by what the CAA defines as fit to hold a class 1 or 2 medical, know the procedures for when there's a problem, and they're off! (alright, I'm sure it's a bit more complex than that, but I doubt there's the same outside pressures as a GP might have to deal with)
Add in a smaller patient base with a higher proportion of healthy people who WANT to be healthy because of the benefits that brings (you might be surprised at the number of healthy people who want to be UNhealthy because of the benefits that brings, in GP land!), coupled with the guaranteed customer service quality improver of direct payment for services rendered (docs are motivated by the same things as real people), and I can see why the relationship I have with my AME is different to that I have with my GP.
As mentioned, not a GP, met more than one GP I wouldn't trust with my dog, and every time I try and interact with primary care services I get bored after an hour or two of being buggered about, but I do know that the majority of them are trying to do the best job they can with the sh1tty circumstances being foisted upon them.
I do think some GP receptionists need shooting, however!
The way GPs work is defined almost entirely from without i.e. They're told when to work, who to work with, who they see, when they see them, how long they spend with them, what they say to them, how they say it and what they prescribe. Oh, and who to refer to, when to refer, and how, and what to refer for.
It comes from government either via the PCT, or more directly via the contract they have with govt, which a lot of GP's said at the time would make them more money (sic.) but would affect the care they provide (e.g. you go to your quack with a cough. You get your BP done. tick. Diabetes check. tick. Well man screen. tick tick tick. Off you go with your GP having fulfilled his contract requirements, but you still have a cough!)
Sounds a bit restrictive, maybe?
As far as I can tell, AME's have to prove they're suitably qualified to be AME's, abide by what the CAA defines as fit to hold a class 1 or 2 medical, know the procedures for when there's a problem, and they're off! (alright, I'm sure it's a bit more complex than that, but I doubt there's the same outside pressures as a GP might have to deal with)
Add in a smaller patient base with a higher proportion of healthy people who WANT to be healthy because of the benefits that brings (you might be surprised at the number of healthy people who want to be UNhealthy because of the benefits that brings, in GP land!), coupled with the guaranteed customer service quality improver of direct payment for services rendered (docs are motivated by the same things as real people), and I can see why the relationship I have with my AME is different to that I have with my GP.
As mentioned, not a GP, met more than one GP I wouldn't trust with my dog, and every time I try and interact with primary care services I get bored after an hour or two of being buggered about, but I do know that the majority of them are trying to do the best job they can with the sh1tty circumstances being foisted upon them.
I do think some GP receptionists need shooting, however!
Put perhaps John, you have highlighted the point behind the new contract.
Yes, you go with a cough, no you don't get a cure (mostly there is no cure-it goes on its own.)
So why not make good use of the consultation?
Measuring your BP, getting the correct blood tests for your diabetes, being reminded that smoking/pie eating is bad for you, does make a difference to your long term health. We have evidence to show that.
Farting about with viral coughs does not.
Hurrah- we're getting there But monetary fines aren't needed to motivate patients- safe effective care is enough.
Yes, you go with a cough, no you don't get a cure (mostly there is no cure-it goes on its own.)
So why not make good use of the consultation?
Measuring your BP, getting the correct blood tests for your diabetes, being reminded that smoking/pie eating is bad for you, does make a difference to your long term health. We have evidence to show that.
Farting about with viral coughs does not.
The w is for a suitably qualified nurse who can prescribe for basic complaints.
They would be open 6am until 10pm
They would be open 6am until 10pm
But monetary fines aren't needed to motivate patients- safe effective care is enough.
Plastic PPRuNer
"The way GPs work is defined almost entirely from without i.e. They're told when to work, who to work with, who they see, when they see them, how long they spend with them, what they say to them, how they say it and what they prescribe. Oh, and who to refer to, when to refer, and how, and what to refer for."
Yep, very little autonomy (not like that over here yet, thank God)
And all these "rules" have been worked out by earnest committee people who wouldn't know a hydrocoele from hydrophobia....
So it goes......
Mac
Yep, very little autonomy (not like that over here yet, thank God)
And all these "rules" have been worked out by earnest committee people who wouldn't know a hydrocoele from hydrophobia....
So it goes......
Mac
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Put perhaps John, you have highlighted the point behind the new contract.
Yes, you go with a cough, no you don't get a cure (mostly there is no cure-it goes on its own.)
So why not make good use of the consultation?
Measuring your BP, getting the correct blood tests for your diabetes, being reminded that smoking/pie eating is bad for you, does make a difference to your long term health. We have evidence to show that.
Farting about with viral coughs does not.
Yes, you go with a cough, no you don't get a cure (mostly there is no cure-it goes on its own.)
So why not make good use of the consultation?
Measuring your BP, getting the correct blood tests for your diabetes, being reminded that smoking/pie eating is bad for you, does make a difference to your long term health. We have evidence to show that.
Farting about with viral coughs does not.
So you go to see a health care professional with what you think is a problem, get told "we don't fart about with that" and instead get given loads of stuff that the man in the suit tells you is going to make you better, but nevertheless has nothing to do with why you went, in order to make the consultation "useful"?
How very autocratic!
And here was silly old me thinking the patient was at the center of things.
And no, I don't think anything said here has highlighted the point of the new GP contract.
Later practice opening hours aren't a new idea. They've even been tried out by relatively pro-active GP's who didn't need encouraging by their betters!
They generally tended to close down due to lack of use.
So you go to see a health care professional with what you think is a problem, get told "we don't fart about with that" and instead get given loads of stuff that the man in the suit tells you is going to make you better, but nevertheless has nothing to do with why you went, in order to make the consultation "useful"?
I'll try and be grown up about it though and ignore the word twisting.
Of course the patient is at the centre of things, to suggest otherwise is slightly insulting. If you, the taxpayer, wishes for GP consultations to last 30 minutes, that's ok, but is it truly necessary? And cost effective?
If mad jock, is indeed a mad jock, then it's likely that his contemporaries may have dropped earlier than the 3 score and ten years they deserve.It's not all about fried mars bars-the checks put in place in the new contract do save lives- I'm convinced.
I make no apologies for proactively meeting the patients needs rather than meeting the systems needs.
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Actually thats another major worry for the AME. THe new rules came in about 1 year for the over 40's. Up north we haven't hit the same life numbers as the salad eating munchers down south. Word is we are lagging about 15 years behined the rest of the UK with heart buggeration factor.
But having experenced Mayday hospital and ARI in Aberdeen the jock hospitals really don't give a flying what the money costs they just run over. The difference being treated up north compared to that ****e hole in Croydon is like chalk and cheese.
I don't really worry about the health stuff up north the religious folk should come up and see that darwin theory works. If only deep fried mars bars and pizza's sterilisied the idiots we would soon rule the world apart from devon and cornwall because we don't want them.
But having experenced Mayday hospital and ARI in Aberdeen the jock hospitals really don't give a flying
what the money costs they just run over. The difference being treated up north compared to that ****e hole in Croydon is like chalk and cheese. I don't really worry about the health stuff up north the religious folk should come up and see that darwin theory works. If only deep fried mars bars and pizza's sterilisied the idiots we would soon rule the world apart from devon and cornwall because we don't want them.
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This is simply a factor of the excess health spending per head of Scots compared to England. This has been the case for years. Something to do with either 1. an attempt to correct health imbalances by hosing money into Scottish health services or 2. the fact that England votes Conservative, and Scots don't.
DOI, I'm, a GP in Surrey.
DOI, I'm, a GP in Surrey.
Well mad jock, one thing's for certain.
Hospital 'aint gonna make that much difference to the death rate.
Probably best shipping out the dinosaurs to Cape Town, let 'em spend their time doing a few nip & tucks, and watching lady-boy videos.
And spend the money where it'll make a difference.....
.....pre school education, and boring but systematic primary care.
Hospital 'aint gonna make that much difference to the death rate.
Probably best shipping out the dinosaurs to Cape Town, let 'em spend their time doing a few nip & tucks, and watching lady-boy videos.
And spend the money where it'll make a difference.....
.....pre school education, and boring but systematic primary care.