#General medicines

[fallenclan]

this moon is such a win

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[bearoutofmind]

3 more days to Karakasa Netflix release but it feels like a month....

[deadbaguette]

Penelope, Diomedes, and Odysseus design sketches but you can tell I have a favourite (Penelope)

Just getting something down so I can have a good reference for the future when I draw them together again

[sirsmacks]

got a bit too tired to finish this one so ill just post it, ill probs clean it up at some point

[metamatar]

November 11, 2023—Hospitals in Gaza have been under relentless bombardment over the past 24 hours. Al-Shifa Hospital complex, the biggest health facility where staff for Doctors Without Borders/Médecins Sans Frontiéres (MSF) are still working, has been hit several times, including the maternity and outpatient departments, resulting in multiple deaths and injuries.

The hostilities around the hospital have not stopped. MSF teams and hundreds of patients are still inside Al-Shifa Hospital. MSF urgently reiterates its calls to stop the attacks against hospitals, for an immediate ceasefire, and for the protection of medical facilities, medical staff, and patients.

“We are being killed here, please do something," texted one of MSF's nurses from the basement of Al-Shifa Hospital this morning, where he and his family were sheltering from the incessant bombing. “Four or five families are sheltering now in the basement, the shelling is so close, my kids are crying and screaming in fear.”

"The situation in Al-Shifa is truly catastrophic," said Ann Taylor, MSF's Head of Mission in Palestine. "We call on the Israeli government to cease this unrelenting assault on Gaza’s health system. Our staff and patients are inside Al-Shifa Hospital, where the heavy bombing has not stopped since yesterday.” [...]

MSF denounces this death warrant on civilians currently trapped in Al-Shifa Hospital signed by the Israeli military. There needs to be an urgent and unconditional ceasefire between all warring parties; humanitarian aid must be supplied to the entirety of Gaza now.

At Al-Quds Hospital, MSF has lost contact with a surgeon who is working and sheltering there with his family. Other health facilities, including Al Rantisi Hospital, which MSF has also supported in the past, were reportedly surrounded by Israeli tanks.

(emphasis mine)

[brighteuphony]

On the way back from Tea Country with Chakra-poisoned Kakashi tryna "casually" fish for some info before Sakura comes in with the one-hit KO on accident.

So she's got some complicated feelings for Kakashi as well, though they're a lot milder than what she feels about Sasuke.

There's a moment in my AU where Sakura goes through a deep reflection ritual, in which she has to face Inner Sakura -who is representative of all the ugly truths her day-to-day self hasn't been able to face- and come to terms with who she is.

During that time, she's got to face the music.

The music:

Sasuke is the last prodigal son of a clan that was brutally butchered. He's a genius with one of the most powerful dojutsu out there (that he has no idea how to use) and is coming in hot with more baggage than an airport terminal.

Naruto is not normal. She doesn't know what he is (as in-canon, she finds out after the time-skip and the Sakura from above is right on the cusp of Shippuden), but there's nothing normal about a kid who can pull wild orange chakra and who can fight Gaara's tailed beast and come out on top. He's got the personal attention of the Hokage, but the entire village has banded against him for some reason. He's special.

Kakashi is a war veteran turned Jounin and an infamous ANBU captain (I headcanon that some ANBU names are leaked specifically to generate a healthy level of fear/caution among other villages- which is why we know of Itachi/Kakashi/Shisui very publically) and is ALSO the last prodigal son of an old noble clan.

(No way a bookworm like Sakura didn't consume every publically available scroll on Konoha clans).

It doesn't take the big brains to figure out that he got team 7 specifically to help deal with Sasuke's trauma/teach him about the Sharingan, and put a leash on Naruto (and in the future, when she finds out that Madara was able to control the Kyuubi with the Sharingan as well as the knowledge that Kakashi was Minato's student it becomes even clearer why he got the Sasuke/Naruto combo.)

And Sakura? Sakura is a civilian. No clan, no dojutsu, nothing to her name except great chakra control. She's the literal meat in the meat-grinder of the military machine of Konoha, the acceptable sacrifice in a group of otherwise invaluable shinobi. She's just a...girl. (And it doesn't help that she was obsessed with Sasuke instead of training, furthering the gulf between her and Kakashi.)

Kakashi was absolutely not built to handle her- in fact, Kakashi has NO idea how to relate who hasn't gone through a mountain's worth of trauma or someone who hasn't been ingrained in the shinobi-as-a-tool lifestyle, and even then, he's not fully equipped to handle people who have (lmao Sasuke). Not to mention the man is a prodigy- he has no idea how to teach people who have to work hard to get somewhere in life. How do you teach someone if you've never had to 'work hard' to get there yourself?

So, Sakura understands that Kakashi was put in one of the most ridiculous situations of his career- a situation he had NO idea how to handle. She can forgive him for that. BUT, she can't forgive him for not trying his best.

Sakura spent a lot of time coming to terms with the fact that she rushed into the Chidori/Rasengan combo without a single idea of what she would do, but...Kakashi was a big reason for that.

She was HIS responsibility, and he fumbled that bag. Whatever his reasoning, whether it was to 'protect' her, or whether he thought she was worthless, whatever: he should have TRIED.

Kakashi was an adult with resources aplenty. He recognized that she had stellar chakra control but never bothered to teach her genjutsu or direct her to teachers who could pick up the slack.

And after the accident, he abandoned her again. Being forgotten in lieu of Sasuke and Naruto hurt...but she could heal. Being abandoned as some kind of martyr to Kakashi's failures as a teacher? It's gonna take a while for Kakashi to make that up to her...if he can muster the courage to face her.

Sakura finally understands why he preferred the memorial stone to the living. He already failed the dead, and it's easier to wallow in self-flagellation than it is to try and step up for the living.

Sakura stopped being a coward some time ago, and when Kakashi finally does the same, she'll forgive him.

Thank you so much for sticking with this wall of text! And thank you so much anon for the question! Once again, I really appreciate all the kind words people have been throwing my way. <3 <3 <3

[valtsv]

i'm glad "cool facial scar" is such a common trait in people's ocs because i have a scar that's been there as long as i remember just beneath my lip that i always hated as a kid but now whenever i look in the mirror and see it i think to myself "oh it's my oc trait" and i feel better about it

[psychomusic]

induced to me by my contemporary art exam AND a rewatch of rebels after years that. got me into sabezra unexpectedly AND i updated krita and there were many new brushes i wanted to try

refs (IF U CAN PLS HELP ME FIND THE ORIGINAL COSPLAYERS i can't find anything EDIT: found them!! they're starwars_irl and lionesscosplay on insta. thank you guys <3) and ✨colored version✨ under the cut

i can't find themmmmm I've been looking for 2 days but all i found were uncredited reposts

anyway they look amazing

i really wanted to try greyscaling but I'm not sure it looks good. idk. + while i was making it i was listening to i love you by fontaines d.c. (GREAT SONG FROM A GREAT UNDERRATED BAND) and. the grey fit into that mood much better

also two versions without the sketch lines. where ezra looks happier even if they're uglier

[gray-thistleclan]

THE GATHERING PT2

Gray-Thistleclan is now at war with Deep-MurkClan

[randomly-generated-posts-machine]

No! cisfem will kill the patient! She needs jerma985 to live

[spacedocmom]

Doctor Beverly Crusher @SpaceDocMom You're allowed to be angry at your disabilities and/or illnesses. You don't have to be, but you're allowed to be. Never let anybody police your emotions about your health. I'm here for you to support however you feel about all of it in any given moment. emojis: black heart, blue heart, masked 1:10 PM · Sep 4, 2023

[serpentface]

SPIRITUAL POLLUTION, THE GESTURES AGAINST EVIL, AND ABLUTION: A POST

The concepts of spiritual purity and pollution are central to the Faith of the Seven Faced God (and similar takes on the concept predate it throughout and beyond the immediate Wardi cultural sphere). There is no clean cut distinction between physical and spiritual health in this belief system (these concepts exist as a heavily overlapping venn diagram) and many methods intended to cleanse spiritual pollution address both realms.

The word for the concept referred to as spiritual pollution is 'mesechitse', which can translate to 'blockage' or 'severance' depending on the context (its underlying meaning is a pathway that has been stopped in some capacity).

At its core, spiritual pollution is a corruption of the living spirit (which is carried by/IS the blood). It causes both physical and spiritual problems. Polluted blood flows improperly and does not maintain the body’s natural stasis or integrity, causing or allowing disease or other bodily dysfunctions to occur. Many ailments are seen as wholly physical and internal in nature, occurring directly due to polluted blood flowing improperly and affecting key organs. Other diseases (particularly contagious or infectious disease) are known to be caused by dagi, which are harmful spirits that enter the body through orifices or wounds. A limited number of ailments (most notably pronounced schizophrenia-spectrum disorders or cognitive disabilities, unfortunately) are thought to be caused by possession by more powerful evil spirits.

At its worst, severe spiritual pollution is thought to impact or sever one's connection to God. Summarized very basically, severe pollution = blockage of flow between one's own living spirit and the greater spirit of God, which deprives a person of God's blessings and protection, severs them from the natural cycling of life and death (and prevents their necessary participation) and can put their afterlife in jeopardy.

Some degree of corruption to the living spirit is seen as completely inevitable and managed by the body, which physically expels some polluting agents via urine and feces, as well as menstruation (thus all of these substances are themselves dirty and polluting agents). It is reckoned as impossible for any living body to exist in a Completely spiritually pure state. The goal of cleansing (and broader practices revolving around spiritual integrity) is rather to maintain stasis of the body's natural cycling (and by extension a connection to God's living spirit) and to keep pollution contained and minimized.

If one's immortal soul successfully reaches the afterlife, it is then reborn into a spiritually pure existence incapable of being 'severed' from God in any capacity. God Itself is a spiritually pure being, but Its body and living spirit (the world and its cycles, manifested as Faces) is vulnerable. The purity of God's living spirit (and therefore the life-sustaining functions of the world that all beings depend upon) must be sustained, protected, and restored through right practice, which is what much what the public religion revolves around.

Spiritual pollution is a separate but overlapping concept with:

-Metaphysical vulnerability, the word for which is 'namne couyibase' (literally ‘lacking integrity of Being’). This is a state in which the body and living spirit is considered vulnerable to great change, for good or for bad. These states can have vital and positive uses (they are utilized in many rituals, and it is what allows for conception and birth), but must be entered with caution and intentionality. Uncontrolled namne couyibase can otherwise leave one open to forms of spiritual harm. -Curses, which are targeted infliction of harm (of all sorts- bad luck, evil spirits, etc) onto a person, place, or thing. A spiritually polluted body is has less resistance to curses, and curses can intensify this pollution. -Possession, which is when evil spirits attach themselves to or inhabit the body. In the vast majority of cases, possession does not mean an evil spirit is Controlling the body, merely harming it. A spiritually polluted body has less resistance to possession, and possession can intensify this pollution. -Ritual uncleanliness, which is a state of intensified spiritual pollution that requires complete prohibition from a person from entering sacred spaces or participating in certain rituals until they are made clean. The most common reasons for ritual uncleanliness are active menstruation, being in the mourning period, or having performed a known dirtying action without its required ablution (see below).

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Multiple levels of religious-medical practice are centered around maintaining the body's stasis and cleansing it of mesechitse whenever possible. The methods are both active and passive.

Passive methods include the wearing of protective objects/amulets or having the motifs on household items or as decoration (the most ubiquitous are charms like the pelatoche (lit: '(ocean) eye') or odatochent (lit. 'Gods eyes'), the skimmer woman, or phalluses, and the wearing of gull feathers), in addition to other beneficial/protective iconography (guardian lions are most common, though physical representations of each Face of God have beneficial functions).

Active methods cover a broad swath of rites and behaviors (which is even broader in non-doctrinal folk practices). I'll be focusing here on the two main everyday methods of protection/cleansing (rather than more specialized rites) that are supported by core doctrine and may be performed by anyone, rather than being restricted to priests.

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Gestures against evil

These are the absolute most basic protection methods, comprised of three core gestures.

Purity of intent: the hand is held with the palm facing upward, the pointer and pinky finger extended and the thumb and inner two fingers pressed together. This is the most directly ‘cleansing’ gesture, it attempts to bind uncleanliness within the body and thus to prevent inevitable background level spiritual pollution from the body infecting a pure environment or another person. You mostly perform this gesture while entering/leaving a protected or vulnerable space (literal or figurative).

Protection of spirit: the hand is held with the first two fingers pointed together, held upwards for generalized use or pointed for directed use. This is the simplest of apotropaic gestures, aiming to protect the body and spirit from outside harm. This is commonly used before or while entering contexts seen as physically and/or spiritually dangerous, or to un-aggressively counter an evil eye curse.

Dispelling of evil: The hand is held with the first two fingers pointing together, touched to the lips, and flicked away from the body. In practice, this is most commonly used to prevent attachment by malicious or otherwise harmful spirits that may have been evoked (you might perform this after you speak of someone believed to be an earthbound ghost or refer to an evil spirit directly, or immediately after touching a potentially contagious sick person (ideally followed by ablution)). This will not help you if evil spirits have fully Attached themselves to you, but can remove ones that have been attracted to you. Doing this gesture and flicking in the direction of another person is very rude.

These gestures have separate uses, but will often be performed in conjunction (usually in the order given) as a quick means of protecting oneself and the spaces around them. It is not considered a doctrinal replacement for ablution as it does not actually cleanse the spirit, but it attempts to reduce harm (both sustained and produced by the user).

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Ablutions:

Ablution is spiritually and physically cleansing the body with clean water. The metric for clean water is fairly expansive- ocean water, any flowing water, any clear lake, shallow water sources that are clear and free of (obvious) polluting elements such as animal corpses or unclean animal feces, any clear collected water.

The core requirement of an ablution is for the hands to be cleaned in all circumstances, and for other body parts to be cleansed in addition if the situation requires it. One must fully wet the hands/other affected areas and scrub thoroughly, and then use fresh water to rinse. If you have to clean other parts of your body, you save your hands for last (as they will be used for the cleaning).

It is appropriate to perform ablutions cooperatively, but the person assisting you should participate as well (ie- if you have someone washing your back, they should scrub and rinse their own hands after). Someone considered to be in a ritually unclean state that ablution will not immediately fix (the most common are actively menstruating or being in the midst of the mourning period) should not perform ablutions on others.

Note that there is no Hard distinction between bathing for spiritual cleanliness and bathing for physical cleanliness (there is a separate set of cultural standards for physical hygiene, but most hygiene expectations are Covered by ablution). In most circumstances, ablution is just a regular, sometimes tedious everyday activity rather than a solemn or special occasion.

The ritualized requirements denote that only the hands + any given affected body parts Must be washed, but ablutions will often be an aspect of a full-body bathing routine to meet other hygiene standards. (ie: someone performing ablution before making offerings or eating a meal is only Required to wash their hands, but will very often wash their whole bodies and clean their hair- offerings and a meal are (typically) daily activities, so this is a good time to just get a full bath in while you’re at it). It may additionally involve washing the skin with oil or soap, moisturizing the hair with oil, scraping away dead skin, and applying perfumes. This is not a ritual requirement and is performed because generally, people like to feel clean and smell nice.

The hard physicality of cleansing WITH WATER is KEY to this practice. Per core doctrine, there are no DIY cleansing methods that replace washing with water. If one does not have access to clean water for ablutions, they should not perform offerings whatsoever (but are allowed to pray) until they can be cleansed, and accept that they are receiving spiritual pollution by performing ablution-required tasks in the meantime. A blessing from a priest is the only doctrine-supported spiritually cleansing replacement for water ablutions. In practice many people will use the gestures against evil as a replacement (which is not supported by doctrine and is more common in folk religious practice), and virtually everyone will find ways to get physical contaminants off of their body either way (if you step in dog shit and don't have any water nearby, you're going to wipe it the hell off even if that doesn't make you ritually clean).

Times when such an ablution is generally considered a hard requirement:

Before bloodletting in prayer or making other offerings

Before meals

Before assisting in a birth

After menstruation ends

After receiving penetrative sex

After defecating

After urinating (this isn't as ubiquitously seen as a hard requirement, in a lot of cases people interpret it as 'only if you actually get pee on your hands')

After touching urine

After touching feces (many lines of thought make exceptions for the excrement of cattle and khait due to their clean and sacred status- this makes life a easier for the majority of people who have to use dry dung as fuel)

After touching a dead body (human or animal)

At the end of your mourning period for dead kin (traditionally as part of a larger ritual involving full body submergence in flowing water, rather than as a common ablution)

After touching someone else's blood (aside from rites that require it, in which the blood is expected to be clean and the cross-pollution of living spirit is intentional) (technically includes semen but this does not come up very often)

After touching most sick people (particularly with contagious diseases or any skin ailments)

After recovering from an illness (ablutions will be performed as an aspect of treatment as well)

Before entering most temple's inner shrines (and some temples altogether)

Also a requirement for participation in certain specific rites and/or festivals

The exact nuances on how hard these requirements are sometimes vary, particularly in instances revolving around touch. Official doctrine is that any unclean touch requires ablution, but in common practice this is sometimes reinterpreted as only a hard requirement when the touch occurs to the hands. Most practitioners do not perform an ablution immediately after an unclean touch occurs (if you're a field laborer and step in dung, you're probably going to wait to wash until you retire for the night), and not everyone performs ablutions every single time they 'should'.

Only drawing I have related to ablution under the cut (nudity)

This is one way to do it

[boughclan-clangen]

moon 0, page 4

>the doctor is in.

PREVIOUS || NEXT FIRST

[sneepity-snoop-snorpity-sneep]

I gotta blabber for a sec about how much I appreciate how unique and SO not-simple of an antagonist Olrox is.

like he's introduced as the Vampire Who Kills Richter's Mom, and it was a straight-up murder. Like he fully sought her out, she was in the process of sending her kid overseas most likely because she knew he was coming - even before we fully get Olrox's side of the context, we can tell that shit was personal. Right down to the vivid green eyes, he's giving weirdly chill disney villain vibes. But the entire rest of the show? He's the dude in the bad guy car of the villain train just sitting and judging (OH is he judging) every other person there.

Olrox tracking down and killing Julia Belmont is the most confrontational we ever see him get. Every other scene he's in? He's watching, assessing, sometimes philosophizing, and eventually pulling his own chess moves, but fighting? Rarely! And the additional context of his character makes him even more fascinating!!

Olrox is really one of the only vampires in both Castlevania and C: Nocturne that seems to hold onto a connection to a human's life - even after he's no longer one. He reminisces to Mizrak about being a human during the fall of the Aztec Empire, he chooses to spend his time more like a human than any vamp since Lisa sent Dracula traveling like a human way back when.

Homeboy crossed the Atlantic by fucking ship, at a time when the trip took literal weeks and weeks and he can't even leave his quarters except at nighttime (granted, idk if he *has* a faster way to cross the ocean but it kinda seems like he'd do the ship trip anyways) he chooses to rent a room at an inn instead of staying at the chateau (and boink a cute human in said room, cough cough), and really seems to avoid other vampires - although I'm not sure if that's cuz he just doesn't vibe with 'em in general, or because he really doesn't vibe with the current hot vampire philosophy of the century, which seems to be very heavy-handled colonialism + elitism

I kinda wouldn't be surprised if it's both honestly - given that the only other vampire we meet besides him who spent time in the americas/new world was a literal plantation owning slaver (and unless I misremember, Annette says there were multiple vampires among the rich in St. Domingue), it seems pretty likely to me that whoever turned him was probably a vamp who had a direct hand in the downfall of his nation - coming to the New World specifically for conquest and to seize resources seems like it would be hella appealing for vampires. It would make a LOT of sense for Olrox's standoffish behavior around the other vamps to go back to him having been turned by someone very similar to them, who was probably not just an enemy to him, but part of this massive wave of destructive change in his human life.

like he really gives an impression of actively disliking and withdrawing from every other villain's motivation in this show - and it makes a lot of sense if my speculating is even a little bit close. The vampire's goals in Nocturne would be very nearly the same thing that drove the fall of the Aztec Empire - desire for power and control, justified by some """""natural order"""" hierarchy which really just boils down to 'we want all of this and we're going to indulge in making up a dramatic jerk-off reason why we're entitled to it, since you can't stop us taking it anyways and we've got time'

Dude seems to make little effort to be vampire-like - we rarely see him revel in his power like many other vampires do, as well as seeing him nonchalantly rubbing elbows with humans. He speaks fondly of a man he loved, who he fell for while said guy was still human, TO the other human he is currently crushing on! And I do mean crush, like he doesn't react to or treat Mizrak like a plaything, almost every time we get an Olrox lore-drop it's because he's talking to Mizrak sincerely about things that matter to him. He LIKE-likes this human, to the point of jumping directly into a fight to whisk Le Crush to safety in front of a vampire so powerful he won't directly oppose her! Absolutely fascinating behavior all around.

MAN but I want to see some flashbacks from this guy - as far as we know, vampirism is completely an Old World thing - Europe, Asia, Africa, every other vampire we've seen in both Castlevania shows has been from these continents. Were there even any vamps there at all before europeans landed on the shores of the americas???? I mean, I've heard of one of the old religions in mesoamerica having a suspiciously vampirelike god, but how would that connect to Olrox getting vampirized as a 30ish Aztec man?

MAN OH MAN but I am looking forward to seeing what Olrox gets up to in s2 -I'm burning to know if he's gonna survive the series or not, because despite him being the first villain we meet in Nocturne and doing a deed that usually gets villains the 'karmic death' ending, overall he's not really being written like a bad guy the audience wants to see go down. especially since he's not actually in opposition to our protagonists and has a vested interest in keeping one of Team Good Guys newer members alive. My guess is he's either going to get a similar ending to Isaac, a villain that we root for who actually catches a break and doesn't die, ooorrrrrrrr he's gonna get a Highly Tragic sort of death

[sas-afras]

i kinda don’t get people who characterize maccready as like… secretly generous, or having a heart of gold or anything. like don’t get me wrong i don’t think he’s downright malicious or anything, but the dude is absolutely a selfish jerk once you get past the charming facade. that’s the part that’s compelling!

like, he’s nice enough and open enough with the player once you get high enough affinity with him, but his reactions to player actions still point to him being a jerk overall. the sosu just happens to be in His Circle of people he can be vulnerable with. that includes you, his son, and maybe daisy. everyone else can kick rocks, the same way it was in little lamplight

he HAD to grow up with that kind of “us vs the world, every man for himself” mentality in the capitol wasteland. doing so otherwise gets you killed or taken advantage of, which is just protracted death anyways. having grown up in a place where slavers run rampant, people are all pushing each other further down just to boost themselves up and live one more day, and it’s literally impossible to make renewable food sources because the ground is so poisoned i genuinely don’t blame him for ending up a little tight fisted. the fact that he was the mayor of little lamplight just meant that he ended up being able to accept a few people as His To Protect instead of being a total lone wolf.

the way he reacts to the players open generosity isn’t just for show, he Actually Dislikes when you give stuff away without expecting anything in return. you might need that thing and now its just gone!! that person might see you as a sucker! you give an inch and they’ll take a mile! and it makes sense for his character to be like that considering everything. i don’t get why people want to change that into him just being kind of tsundere.

i understand that having your babygirl blorbo comfort character be a canonical asshole in ways that aren’t just kinda charming can be offputting, but like…. the way he treats the sosu is a very notable exception to the rest of his life & it’s a much more interesting dynamic imo. especially if you’re playing a goody two shoes martyr. but that’s just me

[dxmedstudent]

What do GPs do?

For the past few years, there's been a constant undercurrent of hostility towards the medical field in mainstream media, particularly GPs. Especially from certain conservative former doctors who write in to the Torygraph.

One of the charges levelled against GPs is that they are purpotedly ruining the NHS by not working enough hours. They need to be making more time for appointments and are all shirking.

How do GPs work?

GP work is measured in sessions, defined by the BMA as a 4h 10 minute time slot. 3 hours of this is meant to be clinical time, with some admin time for tasks - meant to be at least and hour. Typically, a whole day will involve a session in the morning and a session in the afternoon.

What do GPs do? The BMA breaks it down here. I also find articles by GPs can be useful for explaining. When not talking to patients, we are sending referrals or liaising with specialists about their care. We are checking blood test results and other investigations that were carried out by the practice, and then informing patients. We are filling prescriptions- each time a patient asks for their prescription to be refilled, a doctor or pharmacist is checking the order and whether it is safe to give, abd whether we are monitiring blood tests and keeping the patient safe. We are reading letters from specialists and actioning their recommendations.

However, in reality, multiple surveys reveal that GPs spend significantly more time working than what they are directly paid for. Whilst a 6 session GP should be spending around 24 hours at work, it's closer to 38 hours on average. GPs report spending up to 40% of their working time on admin - much of it being unpaid time outside of the hours they are contractually hired for. I and most GPs I know routinely stay late at work in order to make sure patient care is completed. We're in before 9am and leave between 7 or 8pm.

Add to that that many might have further responsibilities, especially if they are a partner in the practice.

Funnily enough, full time in general practice is considered to be 8 sessions. That's 4 long days. Gone are the days when anyone would consider a 5 day working week for GPs, because the workload is increasingly intense and sessions generate more paperwork than they used to.

Demand Is Increasing

GPs may be moving towards working less sessions, but that's because our work is getting more complex. As patients live longer, with more complicated combinations of illnesses and treatments, and we exist in a society that has progressively defunded social care and benefits, and impoverished our most vulnerable patients, there are more calls on our time abd attention than ever before. Stripped hospital services are increasingly rejecting our referrals, often inappropriately and against actual guidelines. Services are being pushed onto GPs via shared care agreements that would once have been handled by specialist teams in clinic. Services that we heavily rely on to serve our patients are sometimes defunded or disappear as contracts end or are transferred to new providers. Long wait lists lead to exasperated patients repeatedly seeing their GPs to manage issues that can't be managed well in the community.

There's a narrative in the media that appointments are impossible to get, but in reality, nationally GP surgeries are providing more appointments per month than they did before the pandemic. For example, 25.7 million appointments (excluding Covid vaccinations) were delivered by GP practices in December 2023, an increase of 9% compared to pre-pandemic. Practices are trying to find how to offer more appointments on a budget and how to improve access and find alterantive ways to serve patients; for example online forms, so that phone lines are freed up for vulnerable patients. Many practices are also offering longer appointments as many patients have complex needs.

Let's talk Pay

People also assume GPs are rich, but that's not really the case, especially given most of us wrent working full time. Average pay for a session is somewhere between 10k and 12k a year for each session a week that you work, depending on things like seniority and location. So for example, a 5 session GP earning 10k per session can expect to earn 50k a year. That's barely above the London average salary of 44k for a job that requires medical school, often an additional bachelor's degree and then at least 5 years of postgraduate training at minimum. That's more comfortable than a lot of vulnerable people, but it's nowhere near what most people think. Even if someone is paid higher per session and working more sessions, the average is still closer to 80 or 90k for salaried GP roles.

I've found figures that suggest the average GP salary is just over 100k, but that includes people doing separate private work or being partners, where in reality these are different roles that are paid differently. Partners are effectively shareholders in the practice. Locum or private work is much more lucrative and needs to be considered separately from a standard salaried role.

Some Partners may be earning £100k-150 in a good year, but that will be after working a LOT of overtime outside of their clinics, abd is in line with hospital specialists. The proportion of GPs earning more than that are miniscule. And honestly, if someone is working a ton of extra hours with their local LMC or med school or deanery, or doing a ton of locum work in evenings and weekends, I'm happy for them to be earning more money than me. Extra work and hours should be rewarded.

The Gender Aspect

I think we need to address the fact that complaining about doctors choosing to work less than what is defined as full time, often goes hand in hand with people complaining about women having the temerity to work in medicine. Apparently we're devaluing the profession by making it too female, going part time and having children. Why us ut that nobidy cares about whether men are going less than full time to look after their kids, and whether fathers are missing out on their children's upbringing?

As women, many of us are still facing sexism in our working lives. Whilst still having to deal with the fact that even uf we earn more and work longer hours than our menfolk, we usually end up doing the majority of the childcare and housework. Women in medicine are more likely to go less than full time because we are more likely to feel compelled to take on unpaid labour at home. Like our non medical sisters.

For reference, the full time nursing week in the NHS is 37.5h - with some variation between 36-40h depending on where you work. Working part time would benefit nurses, too. The nursing workforce is mostly women, and yet there's not the same outrage about their working hours or going less than full time, because women being nurses is expected. People don't seem to care about nurses' working conditions or the stresses they are under, and honestly most articles ignore the financial stresses or difficulties of most NHS workers because they are normally focused on doctors as a resource that they want to exploit maximally.

We aren't out there trying to police what hours other professions work - or at least, we shouldn't be. So why does the public feel entitled to dictate what hours doctors should be working? It's not like people are being paid for hours they aren't working!