Jay @ClearThinker66 Twitter profile

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Jay

@ClearThinker66

2 years

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Jay

@ClearThinker66

5 months

@b_berg8 @emmaloffhagen @fizapirani But how do you pronounce quiche? My grandmother called it quickie.

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Jay

@ClearThinker66

5 months

@StevenTimpson2 @b_berg8 @emmaloffhagen @fizapirani Haha! She also called mobiles ‘moh bee lays’!

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Jay

@ClearThinker66

8 months

@DrNeenaJha As a senior paediatrician, I don’t want any PA seeing young children. Like elderly people, they present in highly unusual ways and my three months of paediatrics as a medical student was followed by 10 years of in-depth training.

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Jay

@ClearThinker66

9 months

@suchnerve Yes. I try and explain this to schools. “Why do I need to do that?” requires a brief clear answer for many autistic children, not a telling off for being rude and cheeky.

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Jay

@ClearThinker66

4 months

@IncogAssociate @dr_shibley Sorry, but if you are not equal in knowledge to doctors, which you are not, and if you are not superior, then you must be lesser. That’s harsh but it’s the truth. An abridged fake doctor is not a doctor.

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@ClearThinker66

8 months

@DoctorMayJay Excellent! I hate the fact that my 91-year-old father is being hounded to do cholesterol tests and go on statins. Once someone gets past a certain age, we should be encouraging an enjoyable life and not necessarily a so-called healthy one.

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Jay

@ClearThinker66

1 year

@MurielBlaivePhD It’s a bit of a generalisation, Muriel. I’m not quite a Boomer, but I saw people of all ages very happy indeed to sacrifice children and teens. Those who stood up against it were also boomers in the main. Maybe we don’t put a label on the selfish ones

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Jay

@ClearThinker66

8 months

@Matthew_Hodson Wonderful but sad account of growing up with homosexuality. I was a med student in the 80s, worked as an auxiliary on the HIV awards @and held the hands of men who were dying in there. I had a lot of gay friends, and hated the homophobia. The TV programme “It’s a Sin” made me cry.

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Jay

@ClearThinker66

8 months

@mmamas1973 But if the Daily Fail features editor doesn’t know the difference between a trainee doctor (ie medical student) and a PA, Lord help the general public.

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Jay

@ClearThinker66

4 days

@kiityc Yep. And where is the stethoscope? If I’m doing this, the stethoscope is on the chest all the time listening to the heart rate – how does he even know there is one?

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Jay

@ClearThinker66

5 months

@Nicola52032027 @carlmathisen @StevenTimpson2 @b_berg8 @emmaloffhagen @fizapirani 🤣🤣🤣 or ‘poppetty ping’ which is the Welsh word for a microwave!

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Jay

@ClearThinker66

3 months

@garethkthomas I’ve seen this with lots of my patients. They don’t know how to respond and there is a measure of distrust and confusion which is visceral and not something that they are even aware of. Thank you for the work you do.

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Jay

@ClearThinker66

3 months

@trishgreenhalgh I’m a pretty senior paediatrician and D is the right answer. Children go from fine to not fine in a matter of minutes and nobody has mentioned looking for signs of increased work of breathing. A normal respiratory rate can be a child beginning to tire.

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Jay

@ClearThinker66

6 months

@Ask_foradoctor Not sure medical students could pitch up two hours late just because they’ve got exams. I don’t know how they’re assessed these days but in my day, you’d be really marked down.

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Jay

@ClearThinker66

4 months

@mmamas1973 Why on earth would you be threatened with dismissal for providing your own PPE? Holy hell!

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Jay

@ClearThinker66

1 year

@RomyCerratti I am a doctor and the one hospital admission I had for severe sepsis was a car crash from start to finish; my case ended up on a “near miss panel“ to ‘learn from mistakes’. Being a doctor did not protect me.

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@ClearThinker66

2 months

@ccwild79 Crikey, that made me take a breath. There’s no way I would’ve allowed somebody to say that. The right reaction would have been to congratulate that young guy on having made it.

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Jay

@ClearThinker66

4 months

@ShakinthatChalk This is lovely. I work with these children and sometimes, you get teachers who understands but frequently, you get teachers showing little but dislike and contempt. Thank you for not being the latter.

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Jay

@ClearThinker66

7 months

@wesstreeting Please address medical students with no future, junior doctors with no jobs, GPs without jobs, patients without doctors, and then re-consider your subjective comment about bullying. Highlighting lack of training for certain positions is not bullying. It’s fact.

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Jay

@ClearThinker66

2 months

@IncogAssociate @doctor_dru_ Is it “bloody hard” in speech marks because s’body told you that? Because it’s not. It’s v easy. There are PA schools where over 90% get merits and distinctions which illustrates the ease. Do you have any idea how difficult it is to get a merit or a distinction in med finals?

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Jay

@ClearThinker66

1 month

@DrNeenaJha I’m repulsed that paediatricians and paediatric surgeons kept quiet about this.

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Jay

@ClearThinker66

8 months

@Dr_Done_ I had intensive clinical training. It was turning up every weekday, often at weekends, 2 wks hol/year as a clin med student for 3 yrs. Then had at least 10 yrs of specialist training before becoming a paed consultant. It’s unreal that these people will be considered safe.

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@ClearThinker66

6 months

@mmamas1973 The hospital is calling them ‘experts’. That’s a real problem. 😣

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Jay

@ClearThinker66

3 months

@mattzarb @jk_rowling Please state the false information.

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@ClearThinker66

7 months

@Xeon4f145d96s1 I went to medical school with a historian, a lawyer, two physios, a physiologist, two nurses, a pharmacologist, a maths teacher, geography teacher, a butcher and a mortuary technician. They all did a five year medical degree.

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Jay

@ClearThinker66

4 months

@DrRobgalloway Scary and crucial post. As a paediatrician, the very first teaching I ever had was with the registrar on how to spot sick kids and it’s stuck in my brain forever. 30 years later, babies are still scary and surprising in how quickly they fall.

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Jay

@ClearThinker66

2 years

@DrAseemMalhotra I would be more impressed if some of the doctors stopped hiding and came out and spoke publicly too.

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Jay

@ClearThinker66

6 months

@EmilyJBarley Some of the saddest times of my career, trying to resuscitate still born perfect beautiful babies and trying and trying, but failing as it was too late, then having to carry them in to their parents. It would make me cry.

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Jay

@ClearThinker66

11 months

@LeylsTurk That the nurses rate you. If you’re a competent doctor, but not very nice, they won’t rate you. If you’re a nice person but not very competent, they won’t rate you. Nursing confidence in me is the best compliment I could ever receive.

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Jay

@ClearThinker66

5 months

@draevans It’s rubbish to do it in front of a child. Decimates their self esteem. Just really poor practice. Question to ask is what is the benefit of having the child there.

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Jay

@ClearThinker66

6 months

@gmcuk They don’t have ‘different’ skills, knowledge and expertise – they have ‘fewer/less’. There is nothing that they know that a dr doesn’t but there is a great deal that drs know that they don’t. Your reputation as a drs’ regulator is in tatters. Maybe do something about that first?

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Jay

@ClearThinker66

7 months

@SwailesRuth This is exactly what happens to long-term carers of very disabled and terminally ill children. The child dies, the benefits stop and suddenly there is a family having lost income who have become deskilled because they love their child.

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Jay

@ClearThinker66

5 days

@isitsleepytime Having resuscitated hundreds and hundreds of babies, that’s not the way you do it.

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Jay

@ClearThinker66

8 months

@DrEilidhMaria I cannot believe that any PA is unaware that they may not prescribe.

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Jay

@ClearThinker66

2 months

@parthaskar @gloshospitals As a paediatrician of 30 years, I have issues with clearly inexperienced PAs seeing undifferentiated children including infants.

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Jay

@ClearThinker66

4 months

@doctor_dru_ How very dangerous. You prescribe for someone you have assessed - not at the behest of somebody with less knowledge who will not carry the can.

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Jay

@ClearThinker66

2 years

@maxwellhallel Why didn’t you respect his freedom and simply find another doctor rather than causing trouble? Amazingly, it’s not all about you. It never will be. Just do your own thing but don’t expect others to march to your drum.

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@ClearThinker66

1 year

@A1an_M I don’t think they have forgotten at all. There is just another agenda rumbling on underneath the surface, gathering momentum.

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Jay

@ClearThinker66

8 months

@DCanworth @DrNeenaJha It’s being aware of the myriad causes for a simple symptom. That is not covered in a PA course. It’s not even fully covered in a full medical five-year degree. It’s covered by that plus years of additional training.

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Jay

@ClearThinker66

1 year

@ClareGerada @iDrSunny @DeanEggitt @TheBMA @BMA_GP That’s a ridiculous statement, Clare. It’s like saying a HCA is not less qualified than a Registered Nurse. Baffling nonsense from you.

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Jay

@ClearThinker66

2 months

@JDF_Keswick @NHSEngland How many were done manually? I often find the electronic blood pressure cuffs overread. That’s especially true in children and young people. Also, if it’s not expected, you get the equivalent of white coat hypertension.

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Jay

@ClearThinker66

7 months

@DrNeenaJha Or to eat humble pie, and pretend we don’t know anything. When actually, we have slugged our guts out to get good GCSEs, good A-levels and medical degrees plus postgraduate training.

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Jay

@ClearThinker66

8 months

@DrSteveTaylor This is just dishonest. ‘One of the medics’. Nurses, doctors, pharmacists and physios don’t use such vague language, so why would a PA? They must be coached to introduce themselves like this, just as we were coached to introduce ourselves clearly. *My name is.. and I’m a …..*

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@ClearThinker66

5 months

@Ask_foradoctor @gmcuk 100%. Medical students more able by far to see patients than PAs, but only one of those two groups is allowed to dive straight into seeing undifferentiated patients in A&E and primary care. Makes zero sense.

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Jay

@ClearThinker66

1 year

@thomaswoodcock @mark_toshner Tosh. It’s a constant battle to get past management regardless of how senior you are. I remember doing a massive piece of work about Down syndrome children and the main Child health manager said “We’re not funding that. It’s not like they give anything back to society”

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@ClearThinker66

5 months

@RodricJenkin I saw a 2nd year med student in clinic yesterday. Already planning to go to Australia and fully cognizant of the threat of PAs.

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@ClearThinker66

6 months

@drkeithsiau @anarchomed @ExplosiveEnema2 @RCHTWeCare @FPARCP @BritSocGastro @UKGastroDr @parthaskar @DrAsifQasim @DrLKVaughan @DrSteveTaylor @AlisonGeorge10 @Dr_Done_ @Doctors_Vote If he is supervised by you, and you have signed him off, then you should have full understanding of his prescribing rights or not. You can’t just slide away from that. I’m sorry, but that’s not good enough.

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Jay

@ClearThinker66

2 years

@DrJBhattacharya @EricClapton Whether you believe the incidence of vaccine injury or not, it does exist, no vaccine is 100% safe and every injury case should be medically scrutinised. As doctors, we don’t rubbish other vaccine injury, so why rubbish this?

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Jay

@ClearThinker66

6 months

@PlanB_earth @LawyersAreResp @DoctorsXr The GMC’s job is to protect patients. They show no interest in anything else but suddenly, they’re interested in laptops, this woman staging her own peaceful private protest and other nonsense.

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Jay

@ClearThinker66

6 months

@jkcyriac23 @gmcuk This is very strange. Are you saying that your ‘masters degree’ (where many pre-PA course degrees have little relevance to clinical medicine) is superior to MBBS?

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Jay

@ClearThinker66

2 years

@DrProudman I’ve never heard a man called passionate when he punched the door. We call it aggressive and violent, and you know that.

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Jay

@ClearThinker66

2 months

@DrBenLovell I’ve used it clinically about twice in 10 years and I have one in my medical case. Other than that, I use it frequently to entertain small children who would otherwise be very disruptive. So therefore, it’s worth its weight in gold.

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Jay

@ClearThinker66

2 years

@RedWoman1552 @mikeportsmouth It’s not misogynistic. It’s common sense. If people think they haven’t got any money, they have to spend their money on the right things.

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Jay

@ClearThinker66

11 months

@RachelCurtis82 My Accountant told me about this. They have the right to do that with businesses for some time, and now individually. It’s a stealth attack on our personal privacy and freedom.

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Jay

@ClearThinker66

2 months

@DrNeenaJha I dislike the ‘ expected to see the next patient’ as trainee doctor would’ when they’re not trainee doctors at all. They are doctors. Trainee doctors are medical students.

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Jay

@ClearThinker66

6 months

@MichaelC7389 In paediatrics, nobody is allowed to do this who is not at registrar level or above. Communication skills alone take years of training.

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Jay

@ClearThinker66

7 months

@BenMearns There’s something incredibly insincere about these messages, and they’re just not believable at all, I’m afraid.

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Jay

@ClearThinker66

1 year

@wheezylikesund1 I’ll eat my hat if any management heads roll though. And they keep their pensions. Horrific.

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Jay

@ClearThinker66

4 months

@NurseChristell1 I once dictated heart murmur and it came out as hot mama and I forgot to check the email. 😣 Everybody makes mistakes, everybody understands typos, and all you need to do is contact them and apologise with humour.

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Jay

@ClearThinker66

8 months

@DrEilidhMaria My daughter was in hospital for nearly 10 months, and after she came out of ICU, she was on a busy neurosurgery ward and she literally did not sleep for five days. Every time she tried to fall asleep, she would be woken up by noise. No stage three brain rest. Exhausting.

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Jay

@ClearThinker66

6 months

@jkcyriac23 @gmcuk You wrote ‘comparing a physician associate Masters degree to an undergraduate degree is inaccurate’ which implies the former is superior. Do you think your knowledge was superior having just qualified to a 4th yr med student?

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@ClearThinker66

4 months

@DrEilidhMaria This is one of the few things that has not changed. As a house officer in Surgery and Medicine, I don’t remember receiving any teaching whatsoever. My consultants were however interested in what I wanted to be. My job was to work and provide service full stop.

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@ClearThinker66

2 months

@iDrSunny I know of a mental health nurse who within 3 yrs of completing undergrad studies had set up private practice incl independent prescribing of antipsychotics. None of the GPs will share care with him but that would not be allowed as a mid grade doctor. It’s really pretty dangerous.

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Jay

@ClearThinker66

27 days

@IncogAssociate @simondoyle87 PAs are not being eliminated. They are simply being asked to have a scope commensurate with the degree and intensity of their training. They don’t want this scope and they don’t want the role that they have been trained for, as it’s not the role they want to do.

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Jay

@ClearThinker66

8 months

@DCanworth @DrNeenaJha Standard History and examination and diagnosis does not include the myriad differential diagnoses that I mentioned. Be honest, medical students are not stupid, and if they have to work hard to cram it all into five years, you can’t cram into two.

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Jay

@ClearThinker66

1 month

@ollieburtonmed @cy2456 @ClinOncDoc @BDChadwick @Art_Li @iDrSunny @Cleverclog67596 @ExplosiveEnema2 @RCPhysicians @sashnhs @KSS_PAS @DrAsifQasim @DrLKVaughan @UKGastroDr @parthaskar @mmamas1973 @AlisonGeorge10 I’d love to know whether the consultants who enable all this would happily have their children seen by aPA in paediatrics. I think the answer is no. They’d be asking for the paediatric consultant and they know it.

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Jay

@ClearThinker66

8 months

@Adam_Skeen These are the med leaders who were carefully nurtured by their own seniors as they trained, but have now pulled up the drawbridge to the drs in training who they should be giving equal opps to.

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Jay

@ClearThinker66

4 months

@ClinOncDoc @GSTTnhs I agree. They are there to learn, not fill in gaps to save money, even in a crisis. That’s what paid staff are meant to do.

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Jay

@ClearThinker66

2 years

@JoelBrownMD I agree with the sentiment wholeheartedly but not with tie organisation.

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Jay

@ClearThinker66

7 months

@mmamas1973 Born and raised abroad in poverty, free school meals, 5 secondary level schools in 7 yrs with constant curriculum changes, best subjects at school = Art, modern languages and English. 5 med sch rejections 1st time, scraped in a wk before term started, top 10% at med sch.

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Jay

@ClearThinker66

2 months

@implausibleblog It’s bizarre that they think that medical training as a medical student was somehow not intensive. It’s so intensive that most people apply to medical school don’t get in and many don’t last the distance.

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Jay

@ClearThinker66

8 months

@mmamas1973 That’s a superb way of putting it. Yes, I’ve always been v aware that I’m likely to receive rather different treatment simply because I’m a consultant. That’s actually didn’t happen when I was admitted with severe sepsis 11 years ago, and I nearly died as a result of NHS neglect.

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Jay

@ClearThinker66

3 months

@ClareGerada @Burnt2020 @PatrickMackle4 @edinfringeguide @RCSEd @drphilhammond It’s not subtle, Clare. One group has defined standardised in-depth medical training followed by training programs with rigourous postgraduate exams. The other one doesn’t. There’s nothing subtle about that. So stop fudging it.

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Jay

@ClearThinker66

5 months

@doctor_oxford Didn’t he say all year round. SPF 50. There are plenty of endocrinologists who talk about needing a tiny bit of noonday sun but not a lot. It’s all about context.

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Jay

@ClearThinker66

4 months

@c3convertase They don’t still do that ‘change every three days’ nonsense do they? Crikey, in paediatrics, we keep them going as long as we possibly can and no, we don’t see bacterial endocarditis.

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Jay

@ClearThinker66

1 year

@Joelybarder @DNSWilson He wasn’t saying that. You know he wasn’t, but you still want to bait.

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Jay

@ClearThinker66

1 month

@DrNeenaJha Scary stuff, Neena. The GMC answers to nobody. They are steam rollering ahead with a plan that the last and current governments are on board with, scattering patient choice and safety in their wake.

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Jay

@ClearThinker66

9 months

@SenseiBear44 @AllisonPearson Huge Swedish database studies, amongst many many others, disprove a link between autism and the MMR vaccine. The spectrum of autism is simply more understood these days, so diagnostic pick up is higher.

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Jay

@ClearThinker66

11 months

@veggieequallife I used to go and talk to the consultant radiologist, biochemist etc as a surgical house officer, as I had no SHO, my reg was always in theatre & I didn’t know what I was doing 1/2 the time. They were abs fantastic and nobody ever gave me a hard time. They were glad to be asked.

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@ClearThinker66

1 month

@Burnt2020 There is a big risk that we lose this precious trust that patients put in us as they have quite correctly been led to believe that the training is rigourous, standardised & that there is a huge clinical safety net to only allow those truly capable of practising medicine to do so.

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@ClearThinker66

5 months

@AlisonGeorge10 @NewcastleHosps I agree. It really horrified me when I was working at a big Midlands teaching hospital that the restaurant had almost no fruit (little wizened apples and little else) and the café/shop was full of sugary rubbish.

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Jay

@ClearThinker66

1 year

@JudithWBrighton @sharrond62 Lessons aren’t competitive races.

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@ClearThinker66

5 months

@isitsleepytime It was the bit about him ‘staying at the hospital’ that got me. Are there free rooms that somebody can just stay in if they feel too tired to drive home? Or does he just fall asleep on his arms in the cafeteria for a quick nap?

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Jay

@ClearThinker66

7 months

@JoshuaSoane Scones are best served warm then thick jam, and a dollop of cream. Cream on warm scones turns to a puddle of grease. Cold scones have so much less flavour. No brainer.

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Jay

@ClearThinker66

8 months

@DCanworth @parthaskar @WorthWords @Mary_Tom11 @DrNeenaJha You are digging yourself into the deepest grave. Salaried GPs choose that often because of family matters etc. They are not less qualified or experienced. Maybe just close your X account and grow up.

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@ClearThinker66

4 months

@IncogAssociate @DHSCgovuk @NHSuk @NHSE_WTE @gmcuk @RCPhysicians @FPARCP The guidance comes from your organisation. The most important thing is not your ego but the clarification for patients.

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Jay

@ClearThinker66

3 months

@Dr_Done_ @mrjamesob Wow. Just wow. “A simple chest infection”. Minor things. Most are minor but it’s finding that rare dangerous and significant thing, eg whether a chest infection is actually a thoracic lymphoma, that is crucial. This is extraordinary arrogance.

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@ClearThinker66

2 months

@DrEilidhMaria Bizarre. I spent my entire house officer year clerking patients in; how does an FY1 learn how to take histories and make a differential diagnosis?

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Jay

@ClearThinker66

2 years

@DrMcFillin Let’s not generalise. They are over prescribed but I have seen them save lives , and that’s got to be a good thing. The talking therapy that everybody talks about is well nigh impossible to get on the NHS & often unaffordable privately.

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@ClearThinker66

2 months

@gloshospitals Attacking and shutting down people with perfectly valid points (whilst you denigrate junior doctors, calling them trainee doctors) is such a cowardly move.

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@ClearThinker66

2 months

@PatrickMackle4 @MFTnhs @iDrSunny What l utter nonsense. ‘Fresh eyes’ is somebody more senior to you with wider experience and knowledge. Not somebody with a highly abridged version of medicine lacking in critical thinking.

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Jay

@ClearThinker66

5 days

@Dr__Sarmy I prescribe SSRIs, but citalopram isn’t even first line in that age group.

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@ClearThinker66

6 months

@IncogAssociate @Shamz_141 @InvCoriolis @VishwajeetP4t3l What I actually realise Is that all people like you end up talking about is disrespect when faced w hard facts. It’s not disrespectful to point out that a highly abridged version of med is not the same as med is and is not safe. I’ve never heard you post about patient safety.

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Jay

@ClearThinker66

6 months

@dave_dlt @winter202462091 @drkeithsiau @parthaskar @ExplosiveEnema2 @RCHTWeCare @FPARCP @BritSocGastro @UKGastroDr @DrAsifQasim @DrLKVaughan @DrSteveTaylor @AlisonGeorge10 @Dr_Done_ @Doctors_Vote But this latter clarification has been met by silence. …

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Jay

@ClearThinker66

6 months

@DrNeenaJha There is no GMC for them. No NMC. There seems to be no comeuppance. If a medical student prescribed CDs, they would be lucky to be allowed to qualify.

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Jay

@ClearThinker66

8 months

@draevans Or being discharged because they ‘won’t come into the clinic room’…. what about going out to the car park and sitting in the car with them or walking around the car park with them and doing it that way. It’s perfectly possible.

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Jay

@ClearThinker66

9 days

@Dr_BellaR I agree. Every other country prioritises their graduates and we should do the same.

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@ClearThinker66

2 months

@socio_plath If you diagnose a personality disorder, you can get away with not offering any treatment and it’s much cheaper. Cynical but true.

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@ClearThinker66

2 months

@iDrSunny They don’t, nor the broad diagnostic skills. A physiotherapist will be very likely the best person to see an MSK patient but otherwise, I don’t see that they have those skills.

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