In reply to Thickhead:
> Have you any experience of working in primary care? Just out of interest, not a criticism.
I'm a pathologist with the usual low medical school exposure to primary care, 3 months with one practice during medical school, and a few weeks here and there throughout the rest of med school. Most of my experience comes as a patient, or rather as a patient's father, and coming up against people who don't even know the basics of, for example, asthma symptomology, and vicariously through my father, who was a GP who then went into general surgery and then A+E / trauma / pre-hospital care etc
> Training certainly needs extending.
Definitely, if hospitals keep closing, centralisation increases, and the governments plans progress to making GPs the linchpins of the NHS.
> Laziness is rife throughout hospital medicine as much as any other trade or profession in the UK.
I see a binary class of people; 1 camp or the other, 1 camp is dedicated and inexorably hard working, others get away with what they can, there seems to be few in between, but the latter is not a majority. What I do see is much negative defensive medicine where doctors don't have the proper knowledge and subsequent knowledge to do their jobs confidently.
> I don't agree with your views on OOH but would admit that some changes need to be made to the current structure.
For me, it's contradictory to the reason for going into medicine in the first place. Sure there needs to be work flexibility for those with children, but going into medicine and training especially as a "family" doctor, is not compatible with a straight opt out of OOHs. In my discipline, its a different problem, we don't go out to seek work, for example, the post mortem rate is through the floor, which means that nobody is getting the ultimate audit of their clinical work (and believe me we need it - e.g. someone who died with metastatic cancer, who had no evidence of any cancer whatever at post mortem. Also, that pathologists are perfectly placed to do fundamental research that moves our understanding and ability to intervene with disease forward, and most pathologists are quite happy to just do service work.