The title says it all. Without doubt general practice is under the spotlight but not always for the best of reasons.
Some pretty shady characters have stepped into the limelight, casting a murky shadow over the rest of us.
Determining whether a GP is performing badly because they are functioning under bad working practices or are simply a bad doctor is quite a challenge and nobody likes a smartarse telling you how to do it.
So far as smart goes, the authors rate high on the Mensa scale. Their trackrecord in primary care management is impressive.
Practice 'away days'with consultative diagnosis is their forte and the book, if you like, is the downloaded version.
It is driven by the recent changes that effectively force GPs to examine their working practices through revalidation and clinical governance - or else. Irvine and Haman steer you away from the 'or else' bit by providing needs assessment, self-examination and consultative advice on your personal and surgery practice. If the examples given are anything to go by, this is not always a pain-free experience and reinforces notions that senior partners are not God - the practice manager merely allows them to think they are.
Spoon-feeding is avoided, with plenty of opportunities for interpretation. Under the heading 'Effective approaches;
planning' the authors give an anecdote which may relate either to hierarchy or clinical guidelines. 'A group of soldiers in the First World War were lost in the Alps. One of them found an old crumpled map in the bottom of his kit-bag. With relief the group followed the map back to the base camp.
When they arrived one of the officers looked at the map and told them it was in fact a map of the Pyrenees. 'Obviously this means either that only officers (GPs naturally) can read a map without turning it upside down. Or that, like guidelines, there are so many maps being produced they all look alike and you may as well just get on with the job and muddle through.
Loosely split and with considerable overlap, it is divided into four parts covering the authors' experience of consultative diagnostics in the light of recent changes, conclusions from this work, advice augmented by case studies and, rather ominously, an extremely short section entitled, 'The Future'. If nothing else it will make you feel that you are not the only poor sod trying to perform a 'Crackerjack' balancing act with too many demands on your time. Revalidation is here to stay, in whatever form it eventually takes, so anyone working in primary care would benefit from reading this book, not least because it saves the£200 per hour or thereabouts charged by diagnostic consultants. Alternatively, you could make the great escape from Kamp General Practice but watch out for the spotlight and for goodness sake get a decent map.