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Currently in primary care our evidence-based medicine is mostly based on evidence derived from secondary care research around which treatments are most effective for patients. Of course, the latest NICE guidelines are very important when choosing which treatment is most likely to effectively treat my patient with cancer, but I’d much rather have been effective in preventing them from getting cancer in the first place.

If I had one wish granted on behalf of my patients it wouldn’t be lifesaving treatment for one individual, no matter how tragic the story. It would be for no patient to have a BMI > 25 or no one to have a QRISK > 10.

I would definitely want to eliminate anxiety and depression in our entire patient population, which is at least two wishes but if you don’t ask you don’t get!

Pie in the sky I know but surely, we could definitely do a lot more towards that than we currently are.

But where do we start? Where do we focus our efforts?

NICE guidance does not contain the answer that’s for sure. It strikes me that we need researchers to work with GPs to understand more about the genuine thorny issues that exercise clinicians in primary care every day and help us to build more evidence around how to increase our impact on them. I’d definitely be up for this. It would be great to be involved in real useful research and help me to grant my own wish(es) at least in some way.

But how would I actually fit it into my already crammed days?

What do you think?

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