Extending the concept of the MDT into the day to day management of complex medical care.

Currently there seems to be a division between the role of the GP and the role of the specialist consultant.

Where a patient has an ILD condition, eg IPF, this may lead to a heart condition or, depending on the medications involved, possibly a liver or kidney condition. Each of these will be managed by different consultants, and so far as I can see, there is not always a huge amount of communication between the disciplines. It is also, more significantly, not clear which of these consultants should be the ‘lead’ contact point for the patient when faced with a change in symptoms, or a deterioration in condition.

Logically you would think it should be the GP who is managing the interactions and who should be the primary contact point for the patient.

This is turn raises the question of whether, for complex cases, there should be a single doctor or senior nurse, who effectively is a ‘named’ contact for the patient.

Another gap

 A lot has happened - but also not a lot has happened.

Terry Lowther passed away last week. He had Sarcoidosis but not sure of what actually caused his death. He was still a councillor right to the end.

I‘m still struggling on with the illness. I get frustrated, seem very impotent. Want to do a lot more than I‘m actually capable of. I think I‘m not capable but I feel guilty for not trying harder. Spend all my time on my computers procrastinating rather than actually doing stuff.

Sometimes very depressed, but most times very content with my life. 

Recently I keep getting the feeling that I‘m just going to pass away in my sleep. Just not feeling very well sometimes, and get very giddy sometimes.

Hoping to get caught up with outstanding jobs soon. Have been into the office a couple of times, and will be going in again tomorrow late morning, till early evening.