Practice reopening

**UPDATE**

The practice is reopening today (Monday) at 1pm.

Apologies to any patients for any disruption.


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The practice staff have received a telephone call from a known violent offender which could be construed as posing a threat of serious violence involving the use of a firearm.

As a result the medical practice is currently locked down. Police officers are in attendance at this time.

Patients are advised not to attend the practice which will remain closed at least until Monday afternoon.

We will update this site with more details as they become available.

Collaborative care will not mean less doctors on PEI

CBC ran a story yesterday about a leaked copy of the draft Hay report into the future of health care on PEI.

I've not read the report, but they make reference to a suggestion that the number of doctors in PEI may be cut. This could obviously cause concern for patients and doctors who might be worried about the effect this might have on their care.

No matter what the report contains, the changes in health care will not reduce the need for doctors in the province. Improvements in health care delivery will mean better care for patients. However, there are lots of reasons why the number of doctors won't be able to be safely reduced in the foreseeable future:

1. There is a huge unmet health need. Better working will help meet, but will not exceed this need.

2. The population is aging.

3. As care improves, people need more care for the complex chronic illnesses that they are living longer with.

4. It will take 15 years to introduce changes across the health care system.

5. As the use of nurses and technicians increases, they will become an increasingly valuable resource, slowing the rate of change and increasing costs.

I'm looking forward to reading the final report when it is published.

Updated Practice Leaflet and website

 We've updated our practice leaflet (our guide for our patients) and our website.

The leaflet was last updated in January, and we've moved offices and had several new members of staff join us since then.  The leaflet has also had it's information about our services updated, and has up to date opening hours included in it.

Please download a copy of the new patient leaflet, print it out, and keep it by your phone.  Or pick up a fresh copy from the practice when you are next in.

SIGN Rockets - Aiming for Best Practice

If you are a hockey fan googling for 'PEI Rockets Sign' and you ended up here a little confused, I apologise.

SIGN guidelines have revolutionised the standard of medical care over the last fifteen years.  They are a series of guidelines produced by the Scottish Intercollegiate Guideline Network and are arguably the best guideline network in the world.  The fact that they are made in Scotland - like so many other wonderful inventions - helps, of course.  The key thing is that they are unbiased.  Vitally, the are completely independent of any pharmaceutical industry influence.  This is because they are funded centrally by the National Health Service in Scotland (they are part of NHS Quality Improvement Scotland)  and don't have to rely on any outside industry funding*.

The national guidelines are now an established part of all family practice in Scotland.  Many of our patients with chronic issues will have come across them already as our Practice Nurses use them in both of our clinics as the basis for our Chronic Issues Reviews.  So, if you have higher blood pressure, or diabetes, or chronic bronchitis, our nurses will use the SIGN guidelines for those conditions as part of your review.  (Specialists may also have noticed that our referral letters to them are based on SIGN Guideline 31: Report on a Recommended Referral Document.)

Basically, the guidelines tell us what we should be doing to provide the best care possible to our patients.  This is called Best Practice.  They do this by evaluating all the available evidence and then grading their advice based on how good the evidence is.  They do this using the Canadian ABCD system - each point has a letter next to it to show how good the evidence is for that advice/treatment.  A is the highest quality, D is the lowest quality.  Often, low quality evidence is because something is very hard to measure, and so is very hard to prove.

Now, SIGN is moving from simply telling us what the evidence is to helping us to actually put that in to practice.  One part of that move is the introduction of SIGN Rockets.  Rockets stands for Recommendations Online: Clinical Knowledge Evidence Translation.  I prefer to think of them as a fast vehicle which takes us (including the patient) on a journey of best care.  (There are other vehicles that we use for this too - such as the excellent 'best BETs' evidence based medical care website or the English National Health Service's Clinical Knowledge Summaries, although sadly you need access to an NHS Proxy Server to use the later).

So, if you come to us with a breast lump, don't be alarmed if we start to talk to each other about putting you on a rocket!  The medical team will simply be making sure that we get you on the path to the best possible care.  This will involve the medical and nursing teams working together using the appropriate SIGN Rocket.

Anyone can read and/or download the SIGN guidelines that we use.  They are available on the SIGN website.




*   In my medical practices I have a have a near-total ban on any information leaflets, guidelines, or equipment that has been funded - even in part - by the pharmaceutical industry.  SIGN are therefore a 'trusted' source of information for us that makes it much quicker and easier to implement good care.  We know straight away that the guidelines are free of outside bias.  In fact, they even have a guideline for the creation of guidelines!  We use other guidelines but - of course - that takes much longer as we need to research the guideline before we can be sure we can trust it.