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Sam Finnikin

@finnikin.bsky.social
474 followers 379 following 33 posts

GP, academic, father. Believe healthcare can do better for people through personalised care. Own opinions, obvs.

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Reposted by Sam Finnikin
Greg Fell @felly500.bsky.social · 28/09/2025
And at this point a reminder of the Naci paper. High prices = opportunity cost and lost lives in net terms This is where the primary care budget is! www.thelancet.com/journals/lan... thread here bsky.app/profile/fell...
thelancet.com
Population-health impact of new drugs recommended by the National Institute for Health and Care Excellence in England during 2000–20: a retrospective analysis
During 2000–20, NHS coverage of new drugs displaced more population health than it generated. Our results highlight the inherent trade-offs between individuals who directly benefit from new drugs and ...
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Sam Finnikin @finnikin.bsky.social · 19/08/2025
My thought looking at this is that it wasn’t written by someone working in primary care. More and more specialists are expecting us to do more and more tests prior to referral. (And there’s more and more specialists whilst GP numbers are nowhere near keeping up)
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Nuffield Department of Primary Care Health Sciences @oxprimarycare.bsky.social · 16/07/2025
Most penicillin 'allergies' aren't real, finds a major trial run by our CTU & led by @universityofleeds.bsky.social. 88% of patients with a penicillin allergy label had it safely removed after testing, meaning: ✅ better treatment for patients 🦠 a vital step in tackling #AntibioticResistance.
phc.ox.ac.uk
Most penicillin 'allergies' not real, finds major trial coordinated by departments Primary Care Clinical Trials Unit
A department Clinical Trials Unit coordinated trial has found most penicillin 'allergies' are not real. Safely removing these incorrect labels can lead to better patient treatment and is a vital step ...
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Alf Collins @alfcollins.bsky.social · 03/07/2025
Fab thread on the ‘genomics revolution’. 1. Might be helpful for a few people with conditions that are closely genetically linked. 2. Most conditions aren’t. 3. The cost will be enormous 4. Lots of people will become unnecessarily anxious 4. Telling people their risk doesn’t change behaviour
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Dave West @ HSJ @davewwest.bsky.social · 24/04/2025
Ministers - more health checks are not game changing, actual action on public health would be game changing as per @sebrees1.bsky.social & co bsky.app/profile/sebr... and @felly500.bsky.social hsj.co.uk/policy-and-r... and @swoolnoughtkf.bsky.social hsj.co.uk/service-rede...
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Reposted by Sam Finnikin
PrescQIPP CIC @prescqipp.info · 08/04/2025
For guidance, advice, campaigns and examples of good practice to tackle medicine waste and improve adherence, head over to our resources. www.prescqipp.info/our-resource... @pharmdeclares.bsky.social @tonyavery.bsky.social
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Paul Glasziou @paulglasziou.bsky.social · 26/02/2025
Looks like a snake oil epidemic on social media: “We analysed almost 1,000 social media posts about 5 popular medical tests. Most were utterly misleading” #overdiagnosis theconversation.com/we-analysed-...
theconversation.com
We analysed almost 1,000 social media posts about 5 popular medical tests. Most were utterly misleading
87% of posts mentioned the benefits of the tests, while only 15% mentioned potential harms.
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Nada Khan @nadakhan.bsky.social · 25/02/2025
Great to speak to @peteredwards.bsky.social for the @bjgp.bsky.social podcast about safety netting in general practice. Some great tips for practice - listen here! 👇 bjgplife.com/episode-196-...
bjgplife.com
Episode 196: How to approach safety netting in general practice
In this episode, we talk to Dr Pete Edwards about effective safety netting practices.
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Lucy Pollock @lucypgeridoc.bsky.social · 23/02/2025
podcasts.apple.com/gb/podcast/t... here’s an 18 min chat w Jonathan about statins in older people. Maybe you know someone like Mrs Evans …
podcasts.apple.com
12. Sensible prescribing in older people with Jonathan and Lucy; Statins
Podcast Episode · Talking Meds - A PrescQIPP podcast · 21/02/2025 · 19m
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Richard Riley (R²) @richarddriley.bsky.social · 13/02/2025
**NEW BMJ PAPER** "Uncertainty of risk estimates from clinical prediction models: rationale, challenges, and approaches" - most models provide just a risk estimate - we argue for presenting associated uncertainty too - includes pros, cons, PPIE & methods Hope helpful! www.bmj.com/content/388/...
bmj.com
Uncertainty of risk estimates from clinical prediction models: rationale, challenges, and approaches
Clinical prediction models estimate an individual’s risk (probability) of a health related outcome to help guide patient counselling and clinical decision making. Most models provide a single point es...
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Centre for Academic Primary Care (CAPC), Bristol @capcbristol.bsky.social · 06/02/2025
What is best practice for giving 'safety netting' advice to parents of acutely unwell children in general practice & what role might AI play? Mavin Kashyap, Damian Roland & Peter Edwards consider the evidence in this recent @bjgp.bsky.social editorial. bjgp.org/content/75/7... #GPsky #PrimaryCare
Mother with child sitting on her knee with doctor writing notes in the background.
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BJGP @bjgp.org · 29/01/2025
Implementation of clinical pharmacists in #PrimaryCare resulted in improvements in prescribing quality, with reductions in the total number of opioid prescriptions and total costs of medicines per patient  doi.org/10.3399/BJGP... 
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Sam Finnikin @finnikin.bsky.social · 21/01/2025
Glad this group have published this thoughtful challenge to current practice. We’ve lost our way somewhat and we wont get back on track without strong and reasoned voices.
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Anish K Patel @anishkpatel.bsky.social · 17/01/2025
Mandatory training has lost its way. Once a tool for learning critical skills, it's now a growing list of endless requirements. If everything is mandatory, is anything truly essential? 🧵
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The Aural Apothecary @auralapothecary.pharmsky.app · 27/12/2024
It’s Twixmas! Why not catch up on some of the great medicines related chat you have missed out on in 2024. Some of our best episodes and fun-related CPD guaranteed.
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Reposted by Sam Finnikin
The Aural Apothecary @auralapothecary.pharmsky.app · 22/12/2024
ICYMI - the world of medicines in 2024 Wrapped by the five apothecaries!
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Sam Finnikin @finnikin.bsky.social · 19/12/2024
I agree. www.bmj.com/content/387/... Direct access to Knee MRI from GP is not, on the whole, helpful. I don't have access and don't want it. Same with back and head MRI. I can honestly say I can't order them so don't have to engage in long and fruitless conversations about why they aren't indicated
bmj.com
More scans, more problems—let’s fund prevention instead
Mathew discusses GP access to magnetic resonance imaging (MRI).1 Multiple studies have been published in which patients without symptoms underwent MRI of the knee and were found to have abnormalities...
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Sam Finnikin @finnikin.bsky.social · 19/12/2024
Important piece by @lucypgeridoc.bsky.social et al in @bmj.com this week. We need better data on harms and benefits of heart failure treatments in frailty to inform SDM. Pts deserve better www.bmj.com/content/387/...
bmj.com
Appropriate management of heart failure in older people with frailty
Guideline directed medical therapy for heart failure for older people with frailty may do more harm than good, say Henry Woodford and colleagues The management of heart failure is evolving. Recent c...
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Nuffield Trust @nuffieldtrust.org.uk · 12/12/2024
NEW BRIEFING by @becksfisher.bsky.social in collaboration with Health Equity Evidence Centre calls for the outdated GP funding formula to be replaced by a needs-based payment to better address health inequalities. 💷 Read here: www.nuffieldtrust.org.uk/resource/fai...
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Alf Collins @alfcollins.bsky.social · 26/11/2024
I’ve heard about 2 ‘referral management’ services in the past week that are clearly designed to keep patients away from waiting lists. Problem is, the experience of the patients I’ve heard from has been appalling. Reminder: It is possible to provide *person centred care and reduce waiting lists*
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Sam Finnikin @finnikin.bsky.social · 06/12/2024
This is a great paper, thanks for posting Tom. It's not good enough for risk prediction tools to be accurate. We must demonstrate that their use is clinically useful and cost-effective before adoption.
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Sam Finnikin @finnikin.bsky.social · 04/12/2024
Love how Bluesky put these two posts together for me….. Do read @ritamc.bsky.social excellent thread on why private primary care is not the answer.
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Thomas Round @drtomround.bsky.social · 03/12/2024
@bjgp.bsky.social @rcgp.bsky.social read Iona Heath’s BJGP Editorial from 20yrs ago on pitfalls of #physicianassociates & particular issues for deprived areas & inverse care pmc.ncbi.nlm.nih.gov/articles/PMC... we need more GPs particularly in deprived areas!
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Dr. Rita McCracken, MD PhD🇨🇦 @ritamc.bsky.social · 03/12/2024
Cautionary tale about potential harms of guideline-based care (more harm with intervention to treat to guideline) … OR … Shining a(nother) light on the magic sauce of longitudinal primary care (versus focused pursuit of surrogate measure targets) 🤨 www.nejm.org/doi/full/10....
nejm.org
Pragmatic Trial of Hospitalization Rate in Chronic Kidney Disease | NEJM
Despite the availability of effective therapies for patients with chronic kidney disease, type 2 diabetes, and hypertension (the kidney-dysfunction triad), the results of large-scale trials examini...
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Steve the Chemist @stevechemist.bsky.social · 30/11/2024
@clarepharmacy.bsky.social might say "A bit blokey " but one of our most edgy and thought provoking podcasts re NHS systems #pharmsky
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Robin Conibere @pharmrj.pharmsky.app · 29/11/2024
Here's @drkevinfernando.bsky.social latesst article, co-authored with the Guideline's team, covering key take-home messages & implications for primary care from the recently updated ESC hypertension guidelines rbnc.cc/hyp24
rbnc.cc
The 2024 ESC Guideline on Elevated Blood Pressure and Hypertension: Implications for Primary Care
Dr Kevin Fernando and the Guidelines in Practice Team explore updated recommendations on hypertension from the European Society of Cardiology
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Sam Finnikin @finnikin.bsky.social · 28/11/2024
The debate on assisted dying has been, on the whole, thoughtful and considered. It’s complex and important. I do wonder whether those opposing assisted dying are, sometimes, holding onto a degree of medical paternalism of a bygone era.
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Reposted by Sam Finnikin
Tarjei W. Havneraas @tarjeiw.bsky.social · 28/11/2024
Good initiative! We published an introduction to instrumental variables article in JCE www.jclinepi.com/article/S089...
jclinepi.com
A Gentle Introduction to Instrumental Variables
Instrumental variables (IV) is a central strategy for identifying causal effects in absence of randomized experiments. Clinicians and epidemiologists may find the intuition of IV easy to grasp by comp...
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Sam Finnikin @finnikin.bsky.social · 27/11/2024
Does anyone else find pts statins being stopped in hospital because of “deranged lfts” - with GP to consider restarting in the community. I’m not sure of the logic of stopping. The statin sure as hell isn’t causing the LFT issue. Is it unsafe to continue? #medsky
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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 25/11/2024
www.newstatesman.com/politics/hea... #surdiagnostic #overdiagnosis Applies across life. Dying patients express a range of emotions; sadness may predominate. "Please order an anti-depressant" wrote the nurse. "I'd start an SSRI" says the med student. Or, maybe, just maybe, this sadness is okay.
newstatesman.com
Our overdiagnosis crisis
Amid a sharp rise in mental health conditions, critics say we have started to pathologise “ordinary human unhappiness”.
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Sam Finnikin @finnikin.bsky.social · 22/11/2024
Gave a lecture today for some Med students. Gathered some instant feedback using polling software…. My kids tell me it’s good 🤨
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Sam Finnikin @finnikin.bsky.social · 21/11/2024
Great HSJ podcast with @davewwest.bsky.social this week. Sensible suggestions from guests on 10-year plan. One thing 'a leading trust CEO, ICS leader and policy guru' all agree on is invest in primary care. Perhaps needs someone form primary care at the table? www.hsj.co.uk/hsj-health-c...
hsj.co.uk
HSJ Podcast: What we want from the 10-year plan
A leading trust CEO, ICS leader and policy guru join the HSJ podcast to tell us what's needed from the government's 10-year health plan.
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Trisha Elliott @trishaelliott.bsky.social · 19/11/2024
Let’s not reduce the art of seeing unwell children to a process of “medicine by numbers” pleads @helensalisbury.bsky.social in the @bmj.com this week. More reasons to cherish relationship based medicine as discussed by @francesmair.bsky.social recently. #GeneralPractice #MedSky #PaedsSky
“Do you remember that child you saw two days ago?” All doctors dread what might come next: we fear that something bad has happened because we missed a clinical sign or made a poor judgment. This kind of worry keeps us all alert, even at the end of a busy day as the duty doctor.

Hospitals have developed scoring systems to help medical and nursing staff gauge how sick a child is, and the Royal College of Paediatrics and Child Health has suggested that these should be rolled out in the community.12 There could be advantages not only in improving detection of children at risk of deterioration but also in shared understanding and ease of handover.

However, research recently published in the British Journal of General Practice found that these scores weren’t useful in primary care.3 They lacked both sensitivity, meaning that they missed a significant proportion of children who needed hospital care, and specificity, advising escalation for many who could safely be looked after at home.

These findings don’t come as a surprise to practising GPs. Early warning systems used on a hospital ward were developed for a different baseline population, as the children there have already been judged to be significantly unwell. Most of the children we see in the community, fortunately, are not.
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Alf Collins @alfcollins.bsky.social · 20/11/2024
1. Many doctors recommend treatments for their patients that they wouldn’t necessarily take themselves. 2. Clinicians & patients tend to overestimate treatment benefits and underestimate harms. 3. Perhaps 20% of health spend is wasted Yet we are pouring £200 billion into the NHS next year. Hmmm
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Sam Finnikin @finnikin.bsky.social · 20/11/2024
I just hard reason to check the spam folder of my academic email address. Wow, that filter is doing some work! I get annoyed at the amount of academic spam I receive but feel a bit better knowing how much doesn't get through. Small things....
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deprescribing.org @deprescribing.bsky.social · 19/11/2024
New to #Bluesky? Join our #deprescribing starter pack. Perfect for #polypharmacy, #medicationoverload, #medicinesoptimisation, #medicationappropriateness, #deprescription, #lessismore friends! DM or reply to be added. go.bsky.app/6MA8eQA
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Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱 @drotte.medsky.social · 18/11/2024
Slowly dipping my toes into research. First substantial offering: bmjopen.bmj.com/content/14/3... We interviewed 12 experts in British Columbia to explore why patients get unnecessary & harmful things, and what helps to avoid this #choosingwisely #quaternaryprevention #lessismore #sensiblemedicine
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Jonathan Griffiths @drjongriffiths.bsky.social · 18/11/2024
New platform, new opportunity to repost some recent blogs. Have done a lot on the Primary Secondary Care Interface and have learned that No one is Trying to do a bad job… drjongriffiths.wordpress.com/2024/05/10/n...
drjongriffiths.wordpress.com
No one is trying to do a bad job – myth busting for the Primary Secondary Care Interface
I remember a consultation with a patient of mine. They had just had an operation. The surgeon had told them that they would need three months off work and provided them with a fit note for two week…
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Sarah J. Jackson @sjjphd.bsky.social · 18/11/2024
Yessssss! Journal editors and board members let’s do this! Folks on academic org committees! We can make the case to at the very least change the “Your Twitter handle” box on everything to something like “Your social media profile” #commsky I for one would be thrilled by “Share to Bluesky”
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Robin Conibere @pharmrj.pharmsky.app · 18/11/2024
“Overtreatment of men with limited longevity for intermediate- and high-risk tumors has not only failed to improve but has actually worsened over the last 20 years,” rbnc.cc/over @mgtmccartney.bsky.social
rbnc.cc
Prostate Cancer Overtreatment Persists
Overscreening and overtreatment of men with prostate cancer and limited life expectancy continue to be an ongoing issue in the era of active surveillance.
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Alf Collins @alfcollins.bsky.social · 18/11/2024
Agree Sam. Evidence suggests we only describe likelihood of benefits and harms and ask patients about ‘what matters’ in about 3-4 in 10 consultations. NHS Resolution ‘failure to inform’ claims (tip of the iceberg) are still going up. Are we focussing too much on elective throughput I wonder?
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Sam Finnikin @finnikin.bsky.social · 18/11/2024
For those interested in #SDM - it's well worth reading this brief and thought provoking essay. journals.sagepub.com/doi/10.1177/... (HT @glynelwyn.bsky.social ) #MedSky
journals.sagepub.com
Sage Journals: Discover world-class research
Subscription and open access journals from Sage, the world's leading independent academic publisher.
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Sam Finnikin @finnikin.bsky.social · 18/11/2024
Interesting commentary on polygenic risk scores (for CVD). I'm sceptical here. We have risk prediction that is good enough (but not used well enough). The vogue for PRSs is, IMO driving by $s not health. It creates a new market, and keeps researchers in business! jamanetwork.com/journals/jam...
jamanetwork.com
Polygenic Risk Scores for Coronary Heart Disease
Risk prediction to inform strategies for the primary prevention of cardiovascular disease is universally recommended by clinical practice guidelines in the US and worldwide.1,2 A risk-based prevention...
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Sam Finnikin @finnikin.bsky.social · 18/11/2024
@jonnyunderhill.bsky.social you were asking about smoking cessation DST (on another forum!) I don't know of one, but there is good info on NHSCT which could form the basis of one: www.ncsct.co.uk/library/view...
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Sam Finnikin @finnikin.bsky.social · 17/11/2024
I’ve made the move! For those who knew me from the other side, please follow. Looking forward to some stimulating and productive discourse for a change!
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