Are nurses the new doctors???
Si in continuare...
UK GPs most stressed in rich world 17/02/2016
British GPs suffer greater stress and less job satisfaction than their counterparts in other wealthy countries, a report warns today.
This may be linked to exceptionally short appointment times, according to the Health Foundation report.
The study found that 92% of GPs in the UK spend less than 15 minutes with patients per appointment on average. This compares with just 27% in other countries.
The findings come from an analysis of data collected by the Commonwealth Fund from 12 wealthy countries including the USA, Australia, Canada and several European countries.
In total more than 12,000 doctors took part in the study, including some 1,000 from the UK.
The report warns that 29% of British GPs want to leave the profession within the five years.
It adds: "These findings show that holding on to existing GPs by improving their working lives should be as great a priority as recruiting new ones."
In contrast the UK is an international leader in the use of electronic medical records, the report says.
The Royal College of GPs said the findings were "no surprise."
Chair Dr Maureen Baker said: “Having such stressed – and exhausted – doctors is a threat to our patients’ safety, our own health, and the sustainability of the NHS as family doctors are becoming dissatisfied with their working circumstances and consider leaving the profession.
"The College has been calling for both workable solutions to reduce GP fatigue in the best interests of patient care, and for measures to be implemented to retain our current workforce, for some time."
She added: “It is also concerning that GP appointments in the UK are the shortest of those countries included in this survey. We want to spend longer with our patients, particularly those with multiple and chronic conditions, for which the standard ten minute consultation is increasingly inadequate – we simply don’t have the capacity to do this as a matter of course. "
Hunt announces junior contract imposition 11/02/2016
The government will seek to impose a new contract on junior doctors this summer, health secretary Jeremy Hunt said today.
He said he was ending "uncertainty" for the service.
But the move is likely to trigger further protests, resignations and potential action from junior doctors.
As it became clear the contract would be imposed today, doctors took to social media in droves to express their dismay.
"I'm utterly horrified," said one.
Speaking to MPs, he claimed the new contract would be "safer for patients and fair and reasonable for junior doctors."
The new contract will be based on Sir David Dalton's "final offer" made on Tuesday night to the BMA, it appeared.
Under this deal about 50% of doctors working on Saturdays would earn extra pay - based on a proposal that doctors would be compensated if they work one in four Saturdays or more.
Mr Hunt accused the BMA of being "ultimately unwilling" to negotiate.
He claimed the new contract "in time" would gain the confidence of the workforce.
He said: "Today we are taking a decisive step forward to help deliver our manifesto commitment."
Shadow health secretary Heidi Alexander told Mr Hunt: "It will destroy morale that is already at rock bottom.
"It will lead to a protracted period of industrial action which is distressing for everyone.
"What does he think the impact will be on recruitment and retention?"
She added: "What happens if they simply refuse to sign?"
The Royal College of GPs was among the first to react, saying it was "shocked and dismayed" at the news.
Si in continuare...
Junior contract imposition looms following strike decision 02/02/2016
An imposed junior doctor contract looked increasingly likely today following the failure of the latest talks and a deadlock on weekend working.
Junior doctors will strike for the second time next week, it was announced yesterday.
Plans for an eight hour all-out strike have been changed to a 24-hour action that continues to provide emergency cover – in the light of the dire state of emergency services.
Two weeks of shuttle diplomacy saw the involvement of government trouble-shooter Sir David Dalton.
Whilst Sir David offered significant concessions on weekend working, the government declined to move away from its drive to make Saturday a normal working day.
In a letter to health secretary Jeremy Hunt yesterday, Sir David said the new contract needs to be agreed by mid-February – shortly after next week’s strike.
He adds: “Should the BMA confirm that they will not negotiate and compromise on weekday and weekend plain time/unsocial hours then I will have to conclude that there is no opportunity for a negotiated settlement, and I would then need to advise you accordingly.”
He adds that a high level of discontent among trainees has been “fermenting” for years – and suggests a review of these concerns by the Academy of Medical Royal Colleges with a view to developing proposals to improve the welfare and morale of trainees.
BMA junior doctors’ committee chair Dr Johann Malawana accused the government of risking souring relations with an entire generation of junior doctors.
He added: “The Government’s entrenched position in refusing to recognise Saturday working as unsocial hours, together with its continued threat to impose a contract so fiercely resisted by junior doctors across England, leaves us with no alternative but to continue with industrial action.
“And to those who would urge junior doctors to resolve their concerns in any way rather than industrial action, I ask: ‘What else would you have us do?’ We have talked in good faith with the Government over the past few months, but have seen no willingness on their part to move on a core issue for junior doctors up and down the country.
“The Government misrepresents junior doctors as a block to a seven-day NHS, but they already work every day of the week. What we are asking is that this is reflected in fair and affordable recognition of unsocial hours.”
• Next week’s strike will use up the days of action notified by the BMA following last year’s 98% vote in favour of strike action.
A government decision to impose a contract would probably trigger another ballot and a wave of action over the summer.
The BMA might also explore other forms of protest – such as refusing to accept posts under the new contract.
Continuarea la postingul precedent...veselie mare in GP land...
GPs threaten mass resignation 01/02/2016
Mass resignation of GPs has moved a step closer as GP leaders warned that patient safety is being compromised by the lack of staff and resources.
At a special conference of Local Medical Committees (LMC), delegates voted overwhelmingly to carry a motion that said the General Practitioners Committee (GPC) should canvass GPs over submitting undated resignations if negotiations with government for a rescue package are not resolved within six months.
BMA GP committee chair Dr Chaand Nagpaul, who supported the motion, also warned that patient safety is being compromised every day because of pressures of workload.
In his keynote speech, Dr Nagpaul said general practice faces an “emergency” situation because of a lack of resources and staff.
“Patients are being short-changed on a daily basis, with nine in ten GPs stating that workload pressures are damaging the quality of care to patients,” he told delegates.
He said the risk of medical error was heightened when GPs have ten-minute appointments to see patients with complex multiple morbidity; he also said a “conveyor-belt style” of appointments, where GPOs see up to 70 patients a day was unsafe. This is on top of the hundreds of clinic letters, pathology results and reams of repeat prescriptions.
“It’s not safe for GPs to be examining patients while simultaneously having to take urgent calls from hospitals, district nurses and social workers, and also be called for an emergency home visit at the same time,” he said.
“It is not safe for practices struggling with unfilled vacancies to be forced to carry on registering patients when they haven’t the doctors or nurses. And it’s not safe to fuel the political hyperbole of routine seven days services, taking GPs away from ill elderly housebound patients in greater need.
“To put it simply, it is not safe to carry on the way we are, and which is why this conference is highlighting that general practice is quite literally in a state of emergency.”
Dr Nagpaul also criticised the Care Quality Commission (CQC), which the BMA says is adding further stress to general practice. Dr Nagpaul said:
“It’s tragic that GPs and practices live in a climate of fear, in which the CQC takes no account of your circumstances, and blames, names and shames you even if you’re running on empty with skeleton staff, or locked into inadequate premises not of your own choosing,” he added.
He concluded by calling on the government to “stop penny-pinching” and to “do the right thing”.
“My message to the chancellor is to use his financial nous – stop penny-pinching and be pound wise, grab yourself a bargain while there are GPs out there because once they're gone they’re gone – since it costs £136 for all-in unlimited care and home visits per patient per year which is less than the price of walking through a single outpatient clinic door once
“I urge government to do the right thing for patients and equally the right thing for a GP workforce whose goodwill continues to be shamefully exploited.”
Cine ar fi crezut vreodata ca se face sistemul medical englez de...ras (era sa zic altceva) in halul asta??? (de la Doctors.net citire)
GPs to threaten mass resignation 18/01/2016
GPs in England could threaten to resign en masse if the government does not agree a “rescue package” for their profession.
The proposal is to be discussed at a special conference of local medical committees later this month.
The proposal comes from the Buckinghamshire local medical committee – but is backed by other areas, such as Norfolk, Northamptonshire and Birmingham.
It would involve GPs signing undated letters of resignation and handing them to BMA negotiators.
GPs will spend a day discussing a range of proposals to deal with the crisis in their profession.
It is likely to agree a call for safe working hours for GPs.
The proposal from Wiltshire local medical committee calls for appointments to be allowed a minimum length of 15 minutes and for “unsafe” 12 hour days to be outlawed.
Dr Chaand Nagpaul, chair of the British Medical Association’s GP committee, said: “The calling of this special conference is a reflection of the untenable situation where relentless workload pressures, soaring demand and funding cuts has meant that GPs are prevented from providing this high standard of care.”
Va tin informati in continuare, folosind aceeasi sursa...
Strikers threatened with “hardening attitudes” as talks convene 08/01/2016
Hospital medical directors and chief executives are to be brought into an advisory panel to help find a solution to the junior doctors’ contract dispute, it was reported last night.
The panel is to be convened by Sir David Dalton, the hospital chief executive brought in as a trouble-shooter by the government today as talks reconvene.
Sir David promised to respect the views of junior doctors – while a separate letter issued by NHS officials threatened striking doctors with a “hardening” of attitudes.
Sir David is set to attend a meeting with arbitrators Acas, along with the NHS Employers and the British Medical Association.
Acas will be attempting to find a deal to prevent Tuesday’s first industrial action by junior doctors – but Sir David indicated he was prepared to take some time in finding a solution.
He said his “priority” was to get a deal good for doctors and for patients.
He said: “I will do my best, but time will tell. What I will do is work in the way that I always have: to listen and respect the views of others.”
He added: “We must all recognise too that both employers and their workforce want to provide the best care to patients and to know that if it was one of their family, that they would have the same access to expertise and facilities seven days a week.”
Linked to Sir David’s comments, junior doctors were emailed yesterday jointly by NHS Employers and Health Education England.
The letter appeared to threaten a “hardening” of attitudes” if strike action went ahead.
It set out in some detail the government’s view of what it is offering and concluded: “As doctors in training, you will now be wrestling with the difficult decision as to whether to participate in the action. Inevitably strike action that disrupts patient care can lead to a hardening of attitudes and make agreement more difficult.
“The action the BMA has announced, particularly withdrawing emergency cover, potentially makes reaching an agreement much harder. We remain committed to supporting a negotiated settlement for your concerns, working with the BMA as your trade union representatives.”
The letter argues that the current definition of unsocial hours for junior doctors is “out of line” with the wider economy and that other similar workers do not receive the same pay increments for working during the evening or at weekends.
But a report in The Independent claimed to show the extent of the government spin operation range against junior doctors. It revealed correspondence lying behind controversial claims in the autumn that a strike would threaten the NHS ability to respond to a “Paris-style” attack.
The statement was made by NHS medical director Sir Bruce Keogh in a letter to the BMA.
But the paper reveals emails suggesting his original draft may have been “hardened.”
Among a series of emails is the statement from a Department of Health official: “I should add that Ministerial views here are, if anything, hardening on the major incident point in the event of public transport also being disrupted on one of the full walkout days; and they also expect that to be something that will be pressed quite hard in the media once the strike is formally announced. So the more hard-edged on this you can be, the better.”
Meanwhile the Daily Telegraph accused BMA officers of issuing an illegal “call to arms” over the strike.
It suggested that call would see supporters gathering on picket lines – something that is illegal under trade union law.
It quotes an article by Dr Yannis Gourtsoyannis, a member of the BMA junior doctors’ committee, stating, under the heading “invitation to attend pickets”: “Many of you will have seen the details with regards to the planned action and I will reiterate them below.
“We invite you to come out and display your visible support for us on the days of action.”
A BMA spokesman told the paper: “It is perfectly legitimate to encourage the public to show visible support for the BMA’s lawful day of industrial activity. The BMA does not and has not endorsed any form of illegal activity.”
Meanwhile the organisation Doctors for the NHS – formerly the NHS Consultants Association – warned of wider implications of the dispute.
Its chair Dr Eric Watts, a haematologist, said: “The NHS has to work to the highest possible standards; everyone is agreed on that. So a career in the NHS means developing doctors’ talents and abilities to the full. This means a career in training which gives them learning experience with adequate time for professional growth – a reflective process with senior support and not being exploited.
“By imposing this contract on the juniors, Hunt threatens that vital need.
“That is what is at stake. Not some vague, Holy Grail of 24-hour service, which this is not about at all.”
Iata ce minunat e sa fii medic in Anglia :)) (de la Doctors.net citire)
Juniors plan extensive action following talks failure 05/01/2016
Junior doctors are set to take industrial action over four days over the next two months following yesterday’s failure of contract negotiations.
The action will be more extensive than had originally planned in December – but a full strike will be delayed until February.
The British Medical Association said there was still scope for “progress” in talks leading to action being called off.
It seemed likely that the next round of talks would take place under the supervision of the arbitration service ACAS.
The first day of action, starting on Tuesday (12th) will start at 8am and will last for 24 hours. During the action, junior doctors will only undertake emergency care.
The second period of action, starting on 26 January, is set to last for 48 hours and will also see junior doctors continuing to provide emergency care.
A one-day strike has then been scheduled for Wednesday 10 February, lasting from 8am to 5pm.
BMA chair Dr Mark Porter said: “We sincerely regret the disruption that industrial action will cause, but junior doctors have been left with no option. It is because the Government’s proposals would be bad for patient care as well as junior doctors in the long-term that we are taking this stand.”
But the Academy of the Medical Royal Colleges called on both sides to continue to work to avert industrial action.
A statement said: “The Academy has consistently called for a negotiated settlement to the dispute around the introduction of a new contract for junior doctors. It is therefore extremely disappointing that talks between the BMA and NHS Employers and the Department of Health have broken down.
“Industrial action will inevitably disrupt services for patients and it is essential that every effort is made to ensure that patient safety is not compromised or patients harmed by any industrial action.
“We would still hope that even at this late stage the parties are able to find a way to reach an agreement without the need for industrial action.”
Chiar asa sa fie?
Does happiness itself directly affect mortality? The prospective UK Million Women Study
Bette Liu, DPhilcorrespondenceemail, Sarah Floud, PhD, Kirstin Pirie, MSc, Prof Jane Green, DPhil, Prof Richard Peto, FRS, Prof Valerie Beral, FRS for the Million Women Study Collaborators
Published Online: 09 December 2015
Open AccessArticle has an altmetric score of 770
DOI: http://dx.doi.org/10.1016/S014.....15)01087-9 |
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Published Online: 09 December 2015
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© 2015 Liu et al. Open Access article distributed under the terms of CC BY.
Tables and Figures
Poor health can cause unhappiness and poor health increases mortality. Previous reports of reduced mortality associated with happiness could be due to the increased mortality of people who are unhappy because of their poor health. Also, unhappiness might be associated with lifestyle factors that can affect mortality. We aimed to establish whether, after allowing for the poor health and lifestyle of people who are unhappy, any robust evidence remains that happiness or related subjective measures of wellbeing directly reduce mortality.
The Million Women Study is a prospective study of UK women recruited between 1996 and 2001 and followed electronically for cause-specific mortality. 3 years after recruitment, the baseline questionnaire for the present report asked women to self-rate their health, happiness, stress, feelings of control, and whether they felt relaxed. The main analyses were of mortality before Jan 1, 2012, from all causes, from ischaemic heart disease, and from cancer in women who did not have heart disease, stroke, chronic obstructive lung disease, or cancer at the time they answered this baseline questionnaire. We used Cox regression, adjusted for baseline self-rated health and lifestyle factors, to calculate mortality rate ratios (RRs) comparing mortality in women who reported being unhappy (ie, happy sometimes, rarely, or never) with those who reported being happy most of the time.
Of 719 671 women in the main analyses (median age 59 years [IQR 55–63]), 39% (282 619) reported being happy most of the time, 44% (315 874) usually happy, and 17% (121 178) unhappy. During 10 years (SD 2) follow-up, 4% (31 531) of participants died. Self-rated poor health at baseline was strongly associated with unhappiness. But after adjustment for self-rated health, treatment for hypertension, diabetes, asthma, arthritis, depression, or anxiety, and several sociodemographic and lifestyle factors (including smoking, deprivation, and body-mass index), unhappiness was not associated with mortality from all causes (adjusted RR for unhappy vs happy most of the time 0·98, 95% CI 0·94–1·01), from ischaemic heart disease (0·97, 0·87–1·10), or from cancer (0·98, 0·93–1·02). Findings were similarly null for related measures such as stress or lack of control.
In middle-aged women, poor health can cause unhappiness. After allowing for this association and adjusting for potential confounders, happiness and related measures of wellbeing do not appear to have any direct effect on mortality.
UK Medical Research Council, Cancer Research UK.
Alarm at specialty exodus 07/12/2015 (from Doctors.net.uk)
Senior doctors have warned of the impact on the NHS of a growing exodus of foundation doctors.
This year just 52% of doctors completing foundation training chose to enter specialty training, according to new figures.
Growing numbers of doctors are taking career breaks or seeking other kinds of appointments, according to the figures from the UK Foundation Programme Office, reported in Doctors.net.uk news on Friday.
Four years ago some 71.3% of foundation doctors went straight into specialty training.
Doctors were making their decisions about the next stage in their careers at the point when junior doctors' leaders had already expressed dismay at what was being offered in a prospective new contract and withdrawn from talks - but before the move to strike action in the last three months.
Speaking to The Guardian, the president of the Royal College of Psychiatrists Professor Sir Simon Wessely described the reduction in specialty applications as "disturbing."
He said: "All this is very worrying. The loss of anything other than a tiny minority of these junior doctors will be a substantial loss to the NHS if these expensively-trained, excellent young medical graduates choose not to pursue a career in the NHS.
“The figures show that more people are less willing to commit themselves to further training to become a GP or consultant in the NHS. They tell us that more and more are reluctant to join the NHS or are hedging their bets."
The chair of the British Medical Association's junior doctors committee, Dr Johann Malawana, said: “These figures should serve as a serious wake up call to the government, and highlight the significant impact that increasing demand, recruitment issues, and falling resources are having on NHS staff.
“The unprecedented pressure combined with the anger and frustration around the government’s plan to impose a new contract, has left many junior doctors voting with their feet.”
De la Doctors.net.uk citire...
Juniors and students reconsidering careers - survey 21/10/2015
Thousands of junior doctors are considering quitting NHS employment if the new contract is imposed, it was reported today.
Nearly 3,000 doctors and medical students in an on-line survey said they would move abroad, become a locum or give up medicine altogether.
The number represented more than 70% of more than 4,000 doctors who took part in the on-line survey, The Guardian reports today.
The figures came as a shortfall in places for next year's Foundation Programme was announced.
The UK Foundation Programme Office confirmed there had been over-subscription but did not give numbers.
It plans to remove applicants without right to work in the UK from the application process before announcing the extent of the problem in January.
Last year the last graduates were fitted into the programme with just a few days to spare.
Government confusion over the row was revealed in a written answer by health minister Ben Gummer, who has wrongly claimed that junior doctors have a weekend opt-out.
Mr Gummer told former health minister Simon Burns: “We want to remove the opt-out from weekend, evening and night working in contracts for newly qualified hospital doctors, so that hospitals arrange their staff rotas evenly though the week and improve provision for junior doctors’ training.”
A minister would normally prepare a written answer with assistance from civil servants.
Numai lapte si miere ca doctor in Anglia...
Placerile psihiatriei in NHS...
Doctors' selfies working at weekends...
De la Doctors.net citire...
Students and migrant doctors to sit single exam 11/06/2015
The next generation of medical students could find themselves sitting a single exam in order to gain their licence to practice as doctors, it has been announced.
The General Medical Council wants the new licensing assessment to be in place by 2021.
It says it wants every doctor to undergo the same assessment to gain a licence to practice in the UK.
The new test, the UK Medical Licensing Assessment, would replace the existing professional and linguistic assessments board test taken by medical graduates from overseas.
It could also become part of the final round of exams at medical school.
GMC chair Professor Terence Stephenson said it would become a "straightforward and transparent" route to medical practice and would "drive up standards."
He said: "Medicine is an increasingly mobile profession and we must have systems in place which not only make sure that UK-trained graduates meet the required standards but that all doctors practising here have been examined and evaluated to the same high level.
"We believe it would be fairer and more reassuring for the public for there to be a standard for entry to the register that everyone can rely on."
He added: "We do not want to create a one-size-fits-all system of undergraduate education – the diversity of our current medical schools can and should be cherished - but we do think all those becoming doctors in the UK should have demonstrated that they have the skills and competence to practise here and have all passed the same assessment before being admitted to the register with a licence to practise."
August 11, 2009
Si tot de la doctors.net vesti nu tocmai bune...
Alarm as stressed GPs plan to quit 15/04/2015
As many as one third of GPs could take retirement within the next five years, it was revealed today.
And another 28% of full-time GPs may switch to part-time work.
The figures from a major British Medical Association survey reveal a looming crisis in general practice amid concern that not enough doctors are training to join the profession.
More than 15,000 doctors took part in the survey.
The BMA said the findings called into question politicians' promises to increase the number of GPs and increase patient access to primary care.
The BMA found that another 9% of GPs would consider moving abroad and another 7% were considering quitting medicine.
Further problems will be posed because 19% of GP trainees like the idea of working abroad.
Some 16% of the doctors reported suffering unmanageable stress while 68% said they faced a significant amount of stress but could manage it.
In spite of these pressures, 47% said they were happy to recommend a career in general practice. But 35% said they would not.
BMA GP committee chair Dr Chaand Nagpaul accused politicians of playing a "numbers game" over general practice.
He said: “It is clear that incredible pressures on GP services are at the heart of this problem, with escalating demand having far outstripped capacity. GPs are overworked and intensely frustrated that they do not have enough time to spend with their patients, especially the increasing numbers of older people with multiple and complex problems who need specialised care.
"Instead GPs are being taken away from treating patients by pointless paperwork or other work that has often been moved without proper resourcing into the community. Many GPs are facing burnout from increased stress."
The findings were backed by the Royal College of GPs.
Chair Dr Maureen Baker said incentives were now being offered for doctors to stay in the profession.
She said: “Highly trained and experienced GPs are leaving the profession in growing numbers because of the intense and increasing pressures that we are facing, and not enough medical students are entering general practice to replace them. This is a genuine danger to patient safety – and to the wellbeing of hardworking family doctors and our teams.
“It costs £247,000 to put a family doctor through post-graduate training, so we must do whatever we can to ‘recruit, retain, and return’ as many GPs to frontline patient care in the UK as possible."
Tot de la Doctors.net citire...
£3,000 for a doctor's shift 24/03/2015
A hospital paid £3,200 for a single 24 hour shift by one doctor, it was reported last night.
The bill was paid by the troubled United Lincolnshire NHS Trust over the Christmas holiday, Sky News reported after making a series of Freedom of Information inquiries.
It found a total of four hospitals that paid more than £2,000 for shifts worked by emergency medicine consultants. The others were in Cornwall, Leeds and Croydon.
It also found three hospitals that paid more than £1,700 a time for nurses to work single shifts.
At the Royal Berkshire Hospital £1,875 was paid for a single nursing shift on New Year's Day - equivalent to £150 an hour.
Similar rates were paid in Derby and in North Bristol.
The research also identified hospitals that had to use locums to fill at least half their shifts in emergency departments over the holiday.
In Airedale locums covered 71% of shifts.
The president of the Royal College of Emergency Medicine Dr Clifford Mann said: "Market forces really are quite extreme currently, with the lack of permanent people to employ.
"It means hospitals are desperate to try to find people to fill these slots and are having to pay super premium rates for that to happen.
"It can be very demoralising to be working alongside somebody with much less experience, much more junior, who is earning a multiple income compared to you in terms of the pounds paid per hour."
* A report from the NHS Trust Development Authority was set to reveal that trusts are spending twice their planned totals on agency staff.
Tot de la Doctors.net, tot din GP land...
Most GPs want early retirement - survey 02/03/2015
Well over half of the UK's GPs expect to quit their jobs before the age of 60, according to a survey published today.
Only 6% of doctors said they would definitely carry on beyond the age of 60 in the survey conducted for the BBC Inside Out programme.
Some 1,004 doctors took part in the survey and 25% said they would definitely give up before the age of 60.
GP Dr Krishna Kasaraneni said today: “In my own practice, two established GPs and one newly qualified GP have moved to Canada and Australia since last summer due to the unsustainable daily pressure facing GPs.
“If this situation becomes normality it will result in an accelerating decline in the overall number of GPs, and will present a threat to patient care as there will be too few GPs for the number of patients walking through the surgery doors."
Dr Kasaraneni, who chairs a British Medical Association training committee, said: "GP services are under unprecedented workload pressure, with practices seeing record numbers of patients - 40 million more annually than in 2008 – against a background of mounting bureaucracy and falling resources.
“This has led to a significant drop in GP morale, and, as the BBC’s survey shows, has led to a worrying number of senior GPs choosing to retire early or work abroad, at the same time that general practice faces a serious shortfall in the number of doctors choosing to train as GPs."
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