[log in to unmask],Net wrote at 15:28 on 12/11/98
about "Quality prescribing/clinical governance":
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>Clinical governance appears to mean quality control
>How can a GP tell a colleague what to do?
Doesn't this happen in partnerships?
If the partnership is extended to everyone in the PCG, as
effectively it is if we are all spending from the same budget and
the left-overs from the budget are what we take home, or to be less
emotive what we use for redecorating and upgrading our buildings.
>And even *more* how can a non-GP??
>From an inappropriate basis of woefully inadequate understanding.
So, you think that will stop them?
>As far as I know our patients' blood pressures are no worse than
average ! >(How can you tell?)
Er, take the average, compare to others?
(allowing for the distribution, skew, the shelf at 160 and so on.
>I try hard to prescribe only one antihypertensive, rather than adding
on all
>the time
Why? I suspect that you may be right, but is there any evidence to
suggest to us which approach is the more effective, or cheapest
equally effective, or best liked by patients?
If there was, then the clinical governor might pop round to anyne
who was very conspicuously departing from it, and the rest of us
would perhaps have limited sympathy.
>So that means I see the patient more often while I get them stable on
one
>drug, maybe trying different ones for a month at a time till I find
the right
>one
>Does that make me a poor quality prescriber?
I wouldn't think so.
Would you like the Clin Guv to talk to people who approach
prescribing for BP by adding on another drug every time they see a
patient whose BP is above a line?
--- OffRoad 1.9r registered to Adrian Midgley
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