Domhnall MacAuley: Middle aged man

Roddy Doyle nailed it. The unspoken aimlessness of middle aged man.  His collection of short stories, “Bullfighting,” was frightening in its ordinariness, the drifting banality of a forgotten tribe. What is left after fatherhood, football coaching, and family? Stories that feature invisible men whose children have grown up, work has plateaued, declined, or disappeared, and stories where the […]

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Domhnall MacAuley: The day the brakes went on

The consortia dream screeched to a halt. As I watched breakfast TV in the airport lounge on my way to the GP forum, the controversial health reforms were unravelling. The forum meeting was entitled “Commissioning Consortia: Examining the comprehensive business and clinical issues for a successful practice-led future” and suddenly, it seemed inappropriate. The health […]

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Domhnall MacAuley: primary care in Brazil

Five of his pregnant patients were dead. Three murdered by drug dealers when they couldn’t pay their bills and two killed by the police.  A very different maternal mortality in frontline general practice.  Marcello Garcia Kolling, a GP in Curitiba, and president of the 2º Congresso Sul Brasileiro de Medicina de Família e Comunidade, estimates […]

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Domhnall MacAuley: Martin Roland in Belfast

Like it or loathe it, practice will never be the same. Constant data audit, screen reminders, and intrusive disease monitoring protocols have, undoubtedly, altered the consultation but, the Quality and Outcomes Framework (QOF) has, I believe, improved my clinical care. At a recent meeting at the Centre of Excellence for Public Health, Northern Ireland, Martin […]

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Domhnall MacAuley: Comprehensivists vs partialists at NAPCRG

Innovative primary care pilot programmes are big news in the US. Money talks, and from a business perspective, primary care is good value. So good, that Paul Grundy’s (US) company IBM provides free primary care to its employees and incentivises referral strategies. Rebranded as the advanced medical home in the US, his model of personal and […]

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Domhnall MacAuley on editors, journals, and Harry Potter

Paddington Bear was at the end of the platform. And, he is still there 15 years later as I travel through London on my way to the BMJ office – still a children’s favourite. But, medical publishing has changed dramatically. Working with Pippa Smart on a training course for medical editors highlighted the transformation. When I first […]

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