CAMPAIGN REPORT ON HEALTHCARE: My medical media - With too little time and too many titles, GPs struggle to keep abreast of the latest medical developments. Dr Martin Marshall reveals his periodicals of choice

The days when doctors could throw away their books after passing their final medical examinations have long gone. I qualified in 1987 and after postgraduate training became a general practitioner in the South-west of England in 1991. In the past seven years I can think of several major advances that have influenced the way I manage common illnesses like heart disease and asthma, never mind the technical advances in managing acute medical and surgical problems. There have been two attempts to restructure the National Health Service that have influenced the way that I provide a service to my patients. Like all healthcare professionals I need to keep up to date with these changes; standing still is not an option.

The days when doctors could throw away their books after passing

their final medical examinations have long gone. I qualified in 1987 and

after postgraduate training became a general practitioner in the

South-west of England in 1991. In the past seven years I can think of

several major advances that have influenced the way I manage common

illnesses like heart disease and asthma, never mind the technical

advances in managing acute medical and surgical problems. There have

been two attempts to restructure the National Health Service that have

influenced the way that I provide a service to my patients. Like all

healthcare professionals I need to keep up to date with these changes;

standing still is not an option.



Of the many sources of clinical and administrative information available

to GPs, some land unsolicited on our desks, others need to be searched

out. As a family doctor I have to know something about most problems

that are brought to me so the volume of literature that I could read is

daunting.



Like most GPs, I have a low threshold for ’dropping in the round

file’.



I bin certain titles without a second glance and I will read the

headlines or table of contents of others through the plastic envelope

and discard if nothing catches my eye.



I can divide my professional reading into four categories. The first

includes weekly news magazines like General Practitioner, Pulse and

Doctor.



The second category offers clinical information, mostly in the form of

summary or review articles, and includes Practitioner and Update. The

third focuses on business or financial information; Medeconomics is my

choice in this area. The final category includes professional academic

journals such as the British Medical Journal, The British Journal of

General Practice, Lancet and Family Practice. I am a part-time senior

lecturer at the Postgraduate School of Medicine and Health Sciences at

the University of Exeter, so I spend three or four hours a week of

protected time reading these journals. In contrast, I read the

non-professional periodicals in ’convenient time’ - over a hurried

sandwich lunch, between seeing patients if I have a gap, or lying in the

bath at the end of a busy day. Often I will carry them around with me

and discard them when the next edition arrives, read or unread. These

snatched moments probably add up to less than 15 minutes a week in

total.



How do I choose what to read? I rarely have time to read all three

weeklies and tend to focus on GP. This is because I’m familiar with its

layout and most of my colleagues read it, so we have a common focus for

discussion. There seems to be little to choose between these magazines

in terms of content or journalistic quality. I tend to read the

front-page stories, scan the headlines on inside stories and

occasionally read the editorials or commentaries. The medical world is a

small one, so I notice articles written by, or on, people I know

personally.



The clinical content of the weeklies tends to be light-weight, so I will

read Update or Practitioner to refresh my clinical knowledge. Articles

on subjects of immediate interest are obviously useful - I might ignore

an article on managing depression one week, but read one in great detail

the next week if I have just had problems managing a depressed

patient.



I might go through a stage of thinking about my pension and will look

for articles on the subject.



I tend not to read the periodicals in sufficient detail to become

familiar with the individual journalists. There are, however, several

authors in the professional journals who I will search out because their

articles are usually thought-provoking or amusing. Most of my colleagues

do the same - we all read Trish Greenhaugh’s anecdotes of her life as an

inner city GP in the British Medical Journal.



It is impossible to escape the pharmaceutical ads in every medical

periodical and journal. I have never consciously read a product

promotion and I naively think that they have little impact on my

prescribing behaviour. However, some ads are hard to ignore - I may not

remember the name of the drug ’endorsed’ by a famous mountaineer who is

also a doctor, or the anti-fungal shampoo picturing a man with mushrooms

growing out of his head, but when a pharmaceutical rep reminds me of an

ad for their product, it has usually stuck in my memory. I would never

prescribe a new product based on the strength of an ad, but marketing

works on multiple messages and by the time a respected independent body

endorses a product, I am already familiar with it.



The number of trade magazines has increased dramatically in recent years

and they keep busy clinicians up to date with current events.Yet few

stand out as exceptional, either in terms of their usefulness or their

entertainment value. It seems to me that the medical weeklies in

particular are stuck in an adolescent stage of development. Few general

practitioners read or value tabloid newspapers, though they may be

faintly amused by them, and yet trade magazines are essentially tabloid

in their presentation and content. Are there any publishers out there

who want their teenage magazines to grow up into adult broadsheets?



Dr Martin Marshall is a GP who is currently taking a well-earned

sabbatical in Los Angeles.



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