Pernicious Anaemia Society
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Do GP's have sufficiently diverse CPD?

I ask this question, because so many comments on here are based upon a GP not following guidelines and often demonstrating low or zero knowledge on this subject.

I briefly discussed this with a relative of mine in the north of England who is heavily involved in medical staff training.

It appears that many GP's specialise, perhaps women's health, pain relief, etc. There appears to be no central structure from CQC, etc detailing how much CPD should be done in things such as gastrointestinal health, etc. Thereafter GP's appear to only do CPD in their specialism. This is not great if your assigned GP specials in women's health and you are a man, etc, etc.

Any thoughts or comments?

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Hi GGourmet

I'll be interested to read comments re your question.

In my opinion, GPs are just that, ie primarily 'general' practitioners, having a wide range of knowledge and knowing when to treat, when to refer to a specialist and who to refer to. Many GPs seem to have areas of particular interest, certainly, but I don't feel this should be at the expense of 'General Practice' skills.

So, if a GP has a special interest in 'Women's Health', for instance, and a male patient goes to see this GP, I don't feel the patient should feel 'short-changed' because doc is less knowledgeable in general areas due to this specialism. This is why we have a referral system to hospital consultants, surely? However, the less serious/complicated illnesses and treatment would likely be more preferable, and more convenient, to the patient if their GP could provide this.

As most GP surgeries now have more GPs, I feel it would be great if each GP were to have a 'special interest' in various areas so the surgery had an across-the-board good range of general knowledge/practice along with a good range of 'specialist' knowledge, whereby a GP can 'refer' a patient to see the GP who has a special interest in that relevant field.

As for Vit B12/Folate/Anaemia/Thyroid etc issues, again, I feel ALL GPs need to be up to speed on these, seeing as these are such a frequent issue and all to often totally overlooked.

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Sorry if a silly question but what is CPD?

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Continuing Professional Development.

This is usually a minimum number of hours per year spent on relevant knowledge updates. Different professions prescribe different regimes for this

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Have just added it to my Abbreviations and Acronyms document:

dropbox.com/s/og3lmxa1dqadb...

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That must be a mighty tome ! I must think about making one myself . So many people use abbreviation speak nowadays !

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Only eleven pages - and that is quite spread out. (I left enough space for people to scribble notes, if needed.) :-)

Mind, I have not included txtspk, and similar, it is meant to be very much to help those coming across unfamiliar medical and related terms. Available to anyone who wishes to click on the link and download it.

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I agree and I wish they wouldn't. It makes reading difficult but then I'm a computer technician and sometimes I also use language others don't understand? I need to 'google' a lot of abbreviations on here but DO I remember after??? that's a million dollar question with no answer!! lol!!

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'Encouraged' I think might just be the problem. In some professions it is mandated.

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Financial services.

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It would be if they were RIPs.

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This would be a requirement to up to 70 hours of CPD where you must undertake relevant CPD in RIPs on top of which you can then do additional specialisation CPD.

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One set of definitions:

specialist - someone who knows everything about nothing

generalist - someone who knows nothing about everything.

To be honest I think medicine covers too many areas and there are two many possible interactions between conditions to really mean that mandating any one set of areas is going to work - especially when the tendency is to look at very broad specialisms and the reality is that conditions like B12 deficiency and PA will be overlooked.

Areas that could probably do with being pushed up the curriculum are clinical diagnostics and some basic mathematics/logic in relation to interpreting tests.

Most GPs now work in practices that rely upon particular specialists working together to share knowledge.

Very few professional organisations actually prescribe curriculum content for CPD - individual members are under an obligation to do CPD that is particularly relevant to them and that is going to very from case to case. Specific curriculum content is generally assosciated with qualification for professional membership.

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I think there needs to be more of a framework to support GPs when they are facing issues they don't know enough about. The GP needs to be able to admit they don't know enough, and to have access to expert advice and the time to seek it. Too often, the result is the patient being dismissed without their problems being properly addressed, yet they still have those problems.

Treating only to the test needs to be looked at. If a test result is "normal" yet the patient is returning over and over, clearly unwell with life altering symptoms, they need help, not dismissal with a "normal" test result, or to be labelled as a "frequent flier" or hypochondriac.

Most of all, there needs to be a huge change in diagnostic skills, root causes of illness need to be examined, not just 'sticking plaster' treatments offered for symptoms, such as anti depressants and NSAIDs.

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I have to agree. Some comments on here chime with my experience. Namely, changing GP in the same surgery just appears to create reinforcement of a previous GP opinion. GP's need to have the confidence and perhaps experience to review a patient independently of another GP. Mine was multiple GP's constantly reporting stress and anxiety. Light bulb moment was the realisation that one of the GP's knew me very well and knew that I had been seriously ill on many occasions and didn't swing the lead. He was the GP that challenged what had gone before and change commenced.

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I have been very lucky with my gp If there is an issue he is not familiar with, he will advise me who to see, or if my request for information is something he has heard of, but not experienced he will research, before suggesting who to see. I am 30 years plus into pa and usually pursue from my gp as much information as I can. I see gp every 6 months who will have one complete blood workup for pa and followed by workup for thyroid and cbc and other work the following 6 months. You must follow closely with gp and lab work and read as much about health conditions as possible and ask questions. It's your body, your health.

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Can I use your experience with your GP in a session I am running at the national GP Conference in Oct on how GPs work with patients to encourage them to educate themselves via the internet and acknowledge that they themselves may not know everything.

I have some info from people with GPs who dismiss anything they come up with, but would like to have a positive example aswell as negatives. It would all be anonymous, but am trying to get GPs thinking about how to respond more positively. It will be from the patient's perspective. I would just use a couple of quotes from your post in my introduction if that's ok.

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I am more than happy for you to use this example, chris193. If you message me I might be able to give you a bit more substance that is perhaps best not widely shared.

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Not sure though if this was meant for me.

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I was told by my GP that other than the injections there was no follow up treatment required.I said I was still getting the neurological symptoms and he said there was nothing else he could do.He knew nothing about the condition and had treated me wrongly on diagnosis.I had a year of severe symptoms before my zB12 was even checked by which time it was 76 and I felt I was dying.I was given 3 monthly injections which made little difference.Only after researching myself did I realise that with severe neurological symptoms I should have been treated differently.

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I was only diagnosed after a year of severe neurological problems which ended in a week in hospital and a year of seeing a consultant neurologist.When my B12 was eventually checked after a month of being almost bedridden it was 76.My GP then treated me wrongly with 3 monthly injections.Only when I did my own research I discovered the treatment. differed if neurological symptoms were present.

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