right OK I just went off for a quick game of DOOM there to get me in the
mood sorry relieve my stress.


<<mistake # 1 - about as useful as reading the lancet from cover to cover -
don't do it >>
I think the Lancet is better, at least you know exactly what you are
getting and the English is considerably more readable.  I didn't even start
on the awful pomposity and verbosity of BJGP authors. 
<< And before you ask why this would be useful, think back to the
number of unfounded "expert" recommendations to GPs to do GHQs to screen
for
depression so everyone can be happy again.>>
But I treat "expert" recommendations a bit like the stuff our new kitten
leaves in dark corners and I *have* already read enough stuff about the GHQ
to know that it would be useful in some situations in GP.  But I accept
that many do not have my particular obsession with psycho-social problems.
<< I reckon it takes 5+ years of full time practice to
know the job before meaningful research is possible - and the incentives to
switch tracks at that stage are not there.>>
i agree--hence the need to support and encourage and develop coal-face GPs
who have the ability to ask useful questions. For instance, I think the
most useful question we could ask right now is how on earth do we cut down
on the crap and make a little more time for the important problems coming
to us in surgery? I see precious little on that in GP papers,  in fact the
absolute opposite.  

<<not the few I know, but getting recognition that anything other than a
cut-and-dried RCT is valid research (whether from funding bodies or from
fellow GPs who then deride RCTs as irrelevant to their daily practice) is
difficult.>>
Bloody hell!  I could live with a journal publishing RCTs. I think that
they are part of the science-dominated medical model which just doesn't
work anymore but at least I might be able to take something useful ouf of a
good RCT.  I can nothing useful out of most of the recent papers in the
college journal and that is at least partly because they fall between hard
scientific studies and properly designed and researched and analysed
sociological/psychological studies.   Plus the aforementioned irrelevance
of the question asked in many cases.

<<Perhaps research networks will provide some answers here - our fledgling
network is already considering studies of BP management in PC and the
safety
of / patient attitudes to warfarin in the elderly amongst several other
things - all derived from day to day clinical problems. Who knows perhaps
one day we'll appear in the BJGP.>
Wonderful!  That is just what is needed in GP.  But maybe you should aim to
publish it somewhere where people might actually read it....

And you can come out of the bunker now.
Declan


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