General Medical Council: From 1 Different Sources
(GMC) the regulatory body of the medical profession in the UK, which was established in 1858 by the Medical Act and has statutory powers. It licenses doctors to practise medicine and has the power to revoke licences or place restrictions on practice. The governing body of the GMC, its Council, comprises 12 members, 6 of which are medically qualified and 6 of which are not. Its purpose is to protect, promote, and maintain the health and safety of the public by ensuring proper standards in the practice of medicine and medical education and training. Following various high-profile cases involving malpractice, there has been a shift in the role of the GMC from one of simple registration to that of *revalidation of doctors.
GMC website: includes the Council’s guide to Good Medical Practice
An outdated term for the tertiary stage of SYPHILIS.... general paralysis of the insane
A detailed review and evaluation of selected clinical records by qualified professional personnel for the purpose of evaluating the quality of medical care.... medical audit
A statutory body set up by the Dentists Act which maintains a register of dentists (see DENTAL SURGEON), promotes high standards of dental education, and oversees the professional conduct of dentists. Membership comprises elected and appointed dentists and appointed lay members. Like other councils responsible for registering health professionals, the General Dental Council now comes under the umbrella of the new Council for Regulatory Excellence, a statutory body. (See APPENDIX 7: STATUTORY ORGANISATIONS.)... general dental council
See DENTAL SURGEON.... general dental services
A form of practice in which medical practitioners provide a wide range of primary health care services to people.... general practice
Under the strict legal de?nition, negligence must involve proving a clearly established duty of care which has been breached in a way that has resulted in injury or harm to the recipient of care. There does not need to be any malicious intention. Whether or not a particular injury can be attributed to medical negligence, or must simply be accepted as a reasonable risk of the particular treatment, depends upon an assessment of whether the doctor has fallen below the standard expected of practitioners in the particular specialty. A defence to such a claim is that a respected body of practitioners would have acted in the same way (even though the majority might not) and in doing so would have acted logically.... medical negligence
A file kept for each patient, maintained by the hospital (medical practitioners also maintain medical records in their own practices), which documents the patient’s problems, diagnostic procedures, treatment and outcome. Related documents, such as written consent for surgery and other procedures, are also included in the record. In addition to facts about a patient’s illness, medical records nearly always contain other information such as clinical, demographic, sociocultural, sociological, economic, administrative and behavioural data. The record may be on paper or computerized.... medical record
A statutory body in the United Kingdom that promotes the balanced development of medical and related biological research and aims to advance knowledge that will lead to improved health care. It employs its own research sta? in more than 40 research establishments. These include the National Institute for Medical Research, the Laboratory of Molecular Biology, and the Clinical Sciences Centre. Grants are provided so that individual scientists can do research which complements the research activities of hospitals and universities. There are several medical charities and foundations – for example, the Imperial Cancer Research Fund, the British Heart Foundation, the Nu?eld Laboratories and the Wellcome Trust which fund and foster medical research.... medical research council
See LIVING WILL.... advance statements about medical treatment
A complete system of theory and practices that has evolved independently of, and often prior to, the conventional biological approach. Many are traditional systems of medicine that are practised by individual cultures throughout the world. Traditional Oriental medicine and Ayurveda, India’s traditional system of medicine, are two examples.... alternative medical system
See APPENDIX 7: STATUTORY ORGANISATIONS.... council for nursing and midwifery
Treatment that is usually considered unable to produce the desired benefit either because it cannot achieve its physiological aim or because the burdens of the treatment are considered to outweigh the benefits for the particular individual. There are necessary value judgements involved in coming to an assessment of futility. These judgements must consider the individual’s, or proxy’s, assessment of worthwhile outcome. They should also take into account the medical practitioner or other provider’s perception of intent in treatment. They may also take into account community and institutional standards, which in turn may have used physiological or functional outcome measures.... futile medical treatment
A hospital providing a variety of services, including medicine and surgery, to meet the general medical needs of the community it serves.... general hospital
Insurance which covers the risk of loss for most accidents and injuries to third parties (the insured and its employees are not covered) which arise from the actions or negligence of the insured, and for which the insured may have legal liability, except those injuries directly related to the provision of professional health care services (the latter risks are covered by professional liability insurance).... general liability insurance
The statutory body that regulates the professions of ophthalmic OPTICIAN (optometrist) and dispensing optician. It promotes high standards of education and professional conduct and was set up by the Opticians Act 1958.... general optical council
Guidelines for doctors on the provision of good medical care laid down by the GENERAL MEDICAL COUNCIL (GMC).... good medical practice
Equipment, such as hospital beds, wheelchairs and prosthetics, provided by an agency and used at home.... home medical equipment
Housing not specifically designed for a particular user group.... mainstream housing / general needs housing
An executive agency of the Department of Health in the UK. Set up in 1994, it is responsible for regulating and advising on the sale or use of any product, other than a medicine, used in the health-care environment for the diagnosis, prevention, monitoring or treatment of illness or disease. Equipment ranges from pacemakers (see CARDIAC PACEMAKER) to prostheses (see PROSTHESIS), and from syringes to magnetic resonance imaging (see (MRI).... medical devices agency
These are UK bodies that provide doctors with advice and, where appropriate, ?nancial support in defending claims for medical negligence in their clinical practice. They also advise doctors on all legal aspects of their work, including patients’ complaints, and provide representation for members called to account by the GENERAL MEDICAL COUNCIL (GMC) or other regulatory body. The sharp rise in claims for medical negligence in the NHS in the 1980s persuaded the UK Health Departments to introduce a risk-pooling system called the Clinical Negligence Scheme for Trusts, and the defence societies liaise with this scheme when advising their doctor members on responding to claims of negligence (see MEDICAL LITIGATION; MEDICAL NEGLIGENCE).... medical defence organisations
See ONCOLOGY.... medical oncology
See “futile medical treatment”; “advanced directive”.... withholding / withdrawing medical treatment
See ETHICS.... world medical association
Quarterly publication of the National Herbalists Association of Australia. Australian medicinal plants, Government reports, case studies, books, plant abstracts. For subscription details and complimentary copy of the Journal contact: NHAA, PO Box 65, Kingsgrove NSW 2208, Australia. Tel: +61(02) 502 2938. Annual subscription (Aus) $40 (overseas applicants include $15 for air mail, otherwise sent by sea mail). ... australian journal of medical herbalism
Legal guidance sought by the sufferer when making claims against a doctor or health authority is available from: Action for Victims of Medical Accidents (AVMA), Bank Chambers, 1 London Road, Forest Hill, London SE23 3TP. ... medical accidents
A general practitioner (‘family doctor’; ‘family practitioner’) is a doctor working in primary care, acting as the ?rst port of professional contact for most patients in the NHS. There are approximately 35,000 GPs in the UK and their services are accessed by registering with a GP practice – usually called a surgery or health centre. Patients should be able to see a GP within 48 hours, and practices have systems to try to ensure that urgent problems are dealt with immediately. GPs generally have few diagnostic or treatment facilities themselves, but can use local hospital diagnostic services (X-rays, blood analysis, etc.) and can refer or admit their patients to hospital, where they come under the supervision of a CONSULTANT. GPs can prescribe nearly all available medicines directly to their patients, so that they treat 90 per cent of illnesses without involving specialist or hospital services.
Most GPs work in groups of self-employed individuals, who contract their services to the local Primary Care Trust (PCT) – see below. Those in full partnership are called principals, but an increasing number now work as non-principals – that is, they are employees rather than partners in a practice. Alternatively, they might be salaried employees of a PCT. The average number of patients looked after by a full-time GP is 1,800 and the average duration of consultation about 10 minutes. GPs need to be able to deal with all common medical conditions and be able to recognise conditions that require specialist help, especially those requiring urgent action.
Until the new General Medical Services Contract was introduced in 2004, GPs had to take individual responsibility for providing ‘all necessary medical services’ at all times to their patient list. Now, practices rather than individuals share this responsibility. Moreover, the contract now applies only to the hours between
8.00 a.m. and 6.30 p.m., Mondays to Fridays; out-of-hours primary care has become the responsibility of PCTs. GPs still have an obligation to visit patients at home on weekdays in case of medical need, but home-visiting as a proportion of GP work has declined steadily since the NHS began. By contrast, the amount of time spent attending to preventive care and organisational issues has steadily increased. The 2004 contract for the ?rst time introduced payment for speci?c indicators of good clinical care in a limited range of conditions.
A telephone advice service, NHS Direct, was launched in 2000 to give an opportunity for patients to ‘consult’ a trained nurse who guides the caller on whether the symptoms indicate that self-care, a visit to a GP or a hospital Accident & Emergency department, or an ambulance callout is required. The aim of this service is to give the patient prompt advice and to reduce misuse of the skills of GPs, ambulance sta? and hospital facilities.
Training of GPs Training for NHS general practice after quali?cation and registration as a doctor requires a minimum of two years’ post-registration work in hospital jobs covering a variety of areas, including PAEDIATRICS, OBSTETRICS, care of the elderly and PSYCHIATRY. This is followed by a year or more working as a ‘registrar’ in general practice. This ?nal year exposes registrars to life as a GP, where they start to look after their own patients, while still closely supervised by a GP who has him- or herself been trained in educational techniques. Successful completion of ‘summative assessment’ – regular assessments during training – quali?es registrars to become GPs in their own right, and many newly quali?ed GPs also sit the membership exam set by the Royal College of General Practitioners (see APPENDIX 8: PROFESSIONAL ORGANISATIONS).
A growing number of GP practices o?er educational attachments to medical students. These attachments provide experience of the range of medical and social problems commonly found in the community, while also o?ering them allocated time to learn clinical skills away from the more specialist environment of the hospital.
In addition to teaching commitments, many GPs are also choosing to spend one or two sessions away from their practices each week, doing other kinds of work. Most will work in, for example, at least one of the following: a hospital specialist clinic; a hospice; occupational medicine (see under OCCUPATIONAL HEALTH, MEDICINE AND DISEASES); family-planning clinics; the police or prison services. Some also become involved in medical administration, representative medicopolitics or journalism. To help them keep up to date with advances and changes in medicine, GPs are required to produce personal-development plans that outline any educational activities they have completed or intend to pursue during the forthcoming year.
NHS GPs are allowed to see private patients, though this activity is not widespread (see PRIVATE HEALTH CARE).
Primary Care Trusts (PCTs) Groups of GPs (whether working alone, or in partnership with others) are now obliged by the NHS to link communally with a number of other GPs in the locality, to form Primary Care Trusts (PCTs). Most have a membership of about 30 GPs, working within a de?ned geographical area, in addition to the community nurses and practice counsellors working in the same area; links are also made to local council social services so that health and social needs are addressed together. Some PCTs also run ambulance services.
One of the roles of PCTs is to develop primary-care services that are appropriate to the needs of the local population, while also occupying a powerful position to in?uence the scope and quality of secondary-care services. They are also designed to ensure equity of resources between di?erent GP surgeries, so that all patients living in the locality have access to a high quality and uniform standard of service.
One way in which this is beginning to happen is through the introduction of more overt CLINICAL GOVERNANCE. PCTs devise and help their member practices to conduct CLINICAL AUDIT programmes and also encourage them to participate in prescribing incentive schemes. In return, practices receive payment for this work, and the funds are used to improve the services they o?er their patients.... general practitioner (gp)
An error or omission in the medical care provided to an individual. Medical errors can occur in diagnosis, treatment, preventive monitoring or in the failure of a piece of medical equipment or another component of the medical system. Often, but not always, medical errors result in adverse events such as injury or death. See also “malpractice”; and “incidence monitoring and reporting”.... medical error
See INFORMATION TECHNOLOGY IN MEDICINE.... medical informatics
This term is used to de?ne the process of learning and knowledge-acquisition in the study of medicine. It also encompasses the expertise required to develop education and training for students and learners in all aspects of medical health care. Studies for undergraduate students, postgraduate students and individual health-care practitioners, from the initial stages to the ongoing development of a career in medicine or associated health ?elds, are also included in medical education. The word ‘pedagogy’ is sometimes applied to this process.
A range of research investigations has developed within medical education. These apply to course monitoring, audit, development and validation, assessment methodologies and the application of educationally appropriate principles at undergraduate and postgraduate levels. Research is undertaken by medical educationalists whose backgrounds include teaching, social sciences and medicine and related health-care specialties, and who will hold a medical or general educational diploma, degree or other appropriate postgraduate quali?cation.
Development and validation for all courses are an important part of continuing accreditation processes. The relatively conservative courses at both undergraduate and postgraduate levels, including diplomas and postgraduate quali?cations awarded by the specialist medical royal colleges (responsible for standards of specialist education) and universities, have undergone a range of reassessment and rede?nition driven by the changing needs of the individual practitioner in the last decade. The stimuli to change aspects of medical training have come from the government through the former Chief Medical O?cer, Sir Kenneth Calman, and the introduction of new approaches to specialist training (the Calman programme), from the GENERAL MEDICAL COUNCIL (GMC) and its document Tomorrow’s Doctors, as well as from the profession itself through the activities of the British Medical Association and the medical royal colleges. The evolving expectations of the public in their perception of the requirements of a doctor, and changes in education of other groups of health professionals, have also led to pressures for changes.
Consequently, many new departments and units devoted to medical education within university medical schools, royal colleges and elsewhere within higher education have been established. These developments have built upon practice developed elsewhere in the world, particularly in North America, Australia and some European countries. Undergraduate education has seen application of new educational methods, including Problem-Based Learning (PBL) in Liverpool, Glasgow and Manchester; clinical and communications skills teaching; early patient contact; and the extensive adoption of Internet (World Wide Web) support and Computer-Aided Learning (CAL). In postgraduate education – driven by European directives and practices, changes in specialist training and the needs of community medicine – new courses have developed around the membership and fellowship examinations for the royal colleges. Examples of these changes driven by medical education expertise include the STEP course for the Royal College of Surgeons of England, and distance-learning courses for diplomas in primary care and rheumatology, as well as examples of good practice as adopted by the Royal College of General Practitioners.
Continuing Professional Development (CPD) and Continuing Medical Education (CME) are also important aspects of medical education now being developed in the United Kingdom, and are evolving to meet the needs of individuals at all stages of their careers.
Bodies closely involved in medical educational developments and their review include the General Medical Council, SCOPME (the Standing Committee on Postgraduate Medical Education), all the medical royal colleges and medical schools, and the British Medical Association through its Board of Medical Education. The National Health Service (NHS) is also involved in education and is a key to facilitation of CPD/CME as the major employer of doctors within the United Kingdom.
Several learned societies embrace medical education at all levels. These include ASME (the Association for the Study of Medical Education), MADEN (the Medical and Dental Education Network) and AMEE (the Association for Medical Education in Europe). Specialist journals are devoted to research reports relating to medical educational developments
(e.g. Academic Medicine, Health Care Education, Medical Education). The more general medical journals (e.g. British Medical Journal, New England Journal of Medicine, The Lancet, Annals of the Royal College of Surgeons) also carry articles on educational matters. Finally, the World Wide Web (WWW) is a valuable source of information relating to courses and course development and other aspects of modern medical education.
The UK government, which controls the number of students entering medical training, has recently increased the quota to take account of increasing demands for trained sta? from the NHS. More than 5,700 students – 3,300 women and 2,400 men – are now entering UK medical schools annually with nearly 28,600 at medical school in any one year, and an attrition rate of about 8–10 per cent. This loss may in part be due to the changes in university-funding arrangements. Students now pay all or part of their tuition fees, and this can result in medical graduates owing several thousand pounds when they qualify at the end of their ?ve-year basic quali?cation course. Doctors wishing to specialise need to do up to ?ve years (sometimes more) of salaried ‘hands-on’ training in house or registrar (intern) posts.
Though it may be a commonly held belief that most students enter medicine for humanitarian reasons rather than for the ?nancial rewards of a successful medical career, in developed nations the prospect of status and rewards is probably one incentive. However, the cost to students of medical education along with the widespread publicity in Britain about an under-resourced, seriously overstretched health service, with sta? working long hours and dealing with a rising number of disgruntled patients, may be affecting recruitment, since the number of applicants for medical school has dropped in the past year or so. Although there is still competition for places, planners need to bear this falling trend in mind.
Another factor to be considered for the future is the nature of the medical curriculum. In Britain and western Europe, the age structure of a probably declining population will become top-heavy with senior citizens. In the ?nancial interests of the countries affected, and in the personal interests of an ageing population, it would seem sensible to raise the pro?le of preventive medicine – traditionally rather a Cinderella subject – in medical education, thus enabling people to live healthier as well as longer lives. While learning about treatments is essential, the increasing specialisation and subspecialisation of medicine in order to provide expensive, high-technology care to a population, many of whom are suffering from preventable illnesses originating in part from self-indulgent lifestyles, seems insupportable economically, unsatisfactory for patients awaiting treatment, and not necessarily professionally ful?lling for health-care sta?. To change the mix of medical education would be a di?cult long-term task but should be worthwhile for providers and recipients of medical care.... medical education
It is sometimes not possible to achieve worthwhile results from herbal medicine without due regard to the quality and type of food that enters the body. Suggested foods are those which experience has shown to assist recovery and conserve body energies that might otherwise be diverted towards elimination of metabolic wastes.
“A good and proper diet in disease is worth a hundred medicines and no amount of medication can do good to a patient who does not observe a strict regimen of diet.” (Charaka Samhita 300AD)
A healthy diet helps maintain the immune system, builds up reserves and hastens recovery from illness.
A good general diet includes foods low in fat, salt and high in fibre. All white sugar and white sugar products (chocolates, sweets, etc) should be replaced with natural sugars (honey, dates, figs, molasses, raisins etc). It should contain plenty of raw fresh fruit and vegetables; best prepared in a juice-press.
Vegetables should be conservatively cooked in very little water with little salt in a covered vessel. At least one mixed raw vegetable salad should be taken daily. Bread can be replaced by jacket potato, Soya- bean flour products or ripe bananas. Puddings, pastry and suety meals should be avoided.
Lean meat should be restricted to two or three parts a week with liberal inclusion of oily fish. Tofu, a Soya bean product, is an excellent alternative to meat. Three or four eggs, only, should be taken weekly.
Dairy produce (milk, butter, cream) contain cholesterol which thickens the blood, blocks arteries and increases resistance against the heart and major blood vessels, and should be taken sparingly.
Accept: Garlic, Onions, Lecithin, Muesli or Oatmeal porridge for breakfast or at other times during the day, yoghurt, honey.
Reject: fried foods, biscuits, confectionery.
Salt: replace with powdered Garlic, Celery or Kelp.
Alcohol: replace with fresh fruit or raw vegetable juices. Coffee is a risk factor raising cholesterol concentration; Dandelion coffee, Rutin or any one of many herbal teas available offer alternatives.
Avoid over-eating and meals when tired. Foods should be well masticated without liquid drinks; dry- feed. Plenty of liquid drinks, water etc should be taken between meals.
Supplements: Vitamin C 200mg, Vitamin E 200iu, morning and evening. Evening Primrose oil. Efamol produce a combined Evening Primrose and Fish oil capsule.
Dietary fibre can prevent certain colonic diseases. Treatment of disease by diet is preferred to drugs because it has the advantage of being free from side-effects. ... diet - general
(AMA) a professional organization for US physicians. Its purposes include dissemination of scientific information through journals, a weekly newspaper, and a website; representation of the profession to Congress and state legislatures; keeping members informed of pending health and medical legislation; evaluating prescription and non-prescription drugs; and cooperating with other organizations in setting standards for hospitals and medical schools. The AMA maintains a comprehensive directory of licensed physicians in the US.... american medical association
(BMA) a professional body for doctors and also an independent trade union dedicated to protecting individual members and the collective interests of doctors. It has a complex structure that allows representation both by geographical area of work and through various committees, including the General Practice Committee (GPC), Central Consultants and Specialists Committee, Junior Doctors Committee, and the Medical Students Committee.... british medical association
(CMO) the most senior medical adviser to the UK government, who is responsible for providing expert advice on health issues (including health-related emergencies). The CMO is responsible to the Secretary of State for Health and acts as leader of profession for Directors of Public Health. There are separate CMOs appointed to advise the devolved governments in Scotland, Wales, and Northern Ireland.... chief medical officer
see community health.... clinical medical officer
Est. 1864. The oldest and only body of professional medical herbalists, now known as phytotherapists, in Europe. Membership by examination after completion of course of training. A stipulated period of clinical practice must be completed before the final examination is taken.
Members are directly involved with patient-care, carrying full responsibility for their recommendations, prescribing medication suitable to the individual biological requirements of each patient. Their role includes patient-counselling, health education and research.
Official recognition of the Institute, indicating its growing importance in the field of medicine came with the historic Grant of Arms by Her Majesty’s College of Heralds. Members regard this as evidence that the Royal Charter of King Henry VIII still stands and that there is no monopoly in healing the sick. See: HENRY VIII, HERBALISTS’ CHARTER.
The Institute played a major role in winning vital concessions for the survival of the herbalist in the passage through Parliament of the Medicine’s Bill. See: MEDICINE’S ACT, 1968.
In connection with the NIMH degree courses in herbal medicine are available at a London University, and Exeter University.
The Institute provides professional indemnity cover for its members, and is engaged in a series of clinical trials to evaluate traditional remedies.
All members are required to adhere to a strict professional Code of Ethics and are entitled to carry after their names the letters of qualification: MNIMH or FNIMH.
Members have a key role in preventative medicine and health promotion in their contribution to improvement of the nation’s health.
Address: 56 Longbrook Street, Exeter EX4 6AH, from which a list of members is obtainable. ... national institute of medical herbalists
Pain along a nerve, i.e. pain in the shoulders from pressure on a spinal nerve serving the neck.
Alternatives. Black Cohosh, Cactus, Chamomile, Lady’s Slipper, Ginseng, Hops, Jamaica Dogwood, White Willow, Wild Lettuce, Valerian.
Chamomile tea (mild analgesic).
Tablets/capsules. Any of the above.
Formula. Ginseng 4; Black Cohosh 2; Skullcap 2; Mistletoe 1; Motherwort 1. Dose: Liquid Extracts: 1 teaspoon. Tinctures: 2 teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily. Children: see: DOSAGE. Cayenne pepper (Capsicum) sometimes successful.
Topical. Poultice: Chamomile, Hops, Linseed or Bran. Acute cases (cold), chronic cases (hot). Grated or bruised Horseradish root. Evening Primrose oil. Hot Cider vinegar, Tincture Arnica or Hypericum. Aromatherapy. 2 drops each: Juniper, Lavender, Chamomile to 2 teaspoons vegetable oil. Light massage. Diet. High protein. Calcium-rich foods.
Supplements. Vitamin B-complex, B6, B12, Niacin, Magnesium, Dolomite, Zinc.
See: FACIAL and INTERCOSTAL NEURALGIA; DYSMENORRHOEA (neuralgia of the womb). ANTISPASMODICS. ... neuralgia, general
the supervisory body of *advanced life-support courses in Europe, responsible for updating the content of the courses based on best evidence from all countries represented.... european resuscitation council
(GHQ) a reliable screening tool published in 1978 for identifying minor psychiatric disorders, still frequently used for research in the general population. The 28-question version (GHQ28) is most commonly used, but the GHQ is available in lengths from 12 to 60 questions.... general health questionnaire
a rolling survey carried out annually (1971–2007) in Great Britain by the *Office for National Statistics. It included questions about the household and questions to be completed by all individuals aged over 16 within the household. It covered a wide variety of topics, such as health, employment, pensions, education, and income. It was succeeded (2007–12) by the general lifestyle survey. See also census.... general household survey
(GPwSI, GPSI) see general practitioner.... general practitioner with special interest
see HEMS.... helicopter-based emergency medical services
(LMC) a group of representatives of the general practitioners working in a defined geographical area. There are separate LMCs for each area, and the members speak on behalf of the local practitioners by whom they are elected. Similar arrangements and responsibilities apply for dentists, pharmacists, and optometrists practising in the NHS outside hospitals.... local medical committee
(GP) a doctor working in the community who provides family health services to a local area. General practitioners (also known as family doctors or family practitioners) may work on their own or in a group practice in which they share premises and other resources with one or more other doctors. GPs are usually the first port of call for most patients with concerns about their health. They look after patients with wide-ranging medical conditions and can refer patients with more complex problems to specialists, such as hospital consultants. Some GPs with additional training and experience in a specific clinical area take referrals for assessment and treatment that may otherwise have been referred directly to hospital consultants; these are known as GPs with a special interest (GPwSI or GPSI). Most GPs work solely within the *National Health Service but a few work completely privately. The current model of general practice allows for GPs to provide general medical services (GMS), the terms and conditions of which are governed by a national contract which is usually negotiated on an annual basis, or personal medical services (PMS), the terms and conditions of which are governed by locally negotiated contracts within a broad framework. The new primary care contract (nGMS contract) came into force in April 2004, allowing GPs to opt out of weekend and night (*out-of-hours) service provision for patients registered with their practice. In this period, patient care is usually provided by an out-of-hours cooperative or deputizing service. At the same time the government also introduced the *Quality and Outcomes Framework (QOF) as a means to improve the quality of care provided. Most GPs are *independent contractors although more recently there has been an increase in the number of salaried GPs. GPs may employ a variety of staff, including *practice nurses, *nurse practitioners, and counsellors.... general practitioner
adj. 1. of or relating to medicine, the diagnosis, treatment and prevention of disease. 2. of or relating to conditions that require the attention of a physician rather than a surgeon. For example, a medical ward of a hospital accommodates patients with such conditions.... medical
1. a health service worker who is not a registered medical practitioner (often in the armed forces) working in association with a doctor to undertake minor treatments and preliminary assessments. In poorer countries, particularly in rural areas where qualified resources are short (e.g. China), agricultural workers receive limited training in health care and continue in a dual role as barefoot doctors; elsewhere, limited training concentrates more on environmental issues: the workers so trained are known as sanitarians. 2. in the USA, a person – licensed or unlicensed, certified or uncertified – who provides administrative and/or clinical assistance in a physician’s office or other health-care facility. Administrative duties typically include filling out insurance forms, billing, and bookkeeping, while clinical duties may include taking medical histories, preparing patients to be examined, and preparing blood and urine specimens.... medical assistant
a certificate stating a doctor’s diagnosis of a patient’s medical condition, disability, or fitness to work (see statement of fitness for work). It is known informally as a ‘fit note’ (formerly a ‘sick note’). See Appendix 8.... medical certificate
see local medical committee.... medical committee
(MET) a team, usually consisting of a group of physicians, anaesthetists, and senior nurses, that can be summoned urgently to attend to patients with deteriorating medical conditions. The aim is to prevent further deterioration and to decide if enhanced levels of care are appropriate (e.g. on the high-dependency or intensive care units). The team will also assume the role of the *cardiac-arrest team.... medical emergency team
the study or practice of the legal aspects of medicine. See forensic medicine.... medical jurisprudence
travelling internationally to undergo surgery or otherwise be treated for an illness or condition. This may be done to save money, to avoid having to wait for treatment, or to receive a treatment not available in the home country.... medical tourism
(NMC) a statutory body that regulates the nursing and midwifery professions in the public interest. See nurse.... nursing and midwifery council
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