💊 Atenolol, 🔈️Awareness Month and 🤖 AI Slop

It’s a pretty Good Friday for medical news, don’t you think?

👋 Happy Friday. Here’s what we got:

If you want to read any previous editions of The Handover, you can on our website.

“Useless”
“Overrated”
“Ineffective”

I’ve heard them all before🥱 

Drugs come and go constantly.
One minute you’re the hottest new thang on the wards (I’m looking at you, GLPs), next you know the hype’s gone, flaws are exposed, and it’s game over. 

But me? I’m built different. 
I’ve been around since the 50s. 
Before your consultant was born. Before your consultant’s consultant was born.

Anxiety? I gotchu
Headaches? Light work, no reaction
Glaucoma? Aqueous humour? never heard of her!

And of course, cardiology. Arrhythmias, angina, hypertension - you name it. 

Cardiologists bow down to me and my beta-blocking-locking-polka-dotting skills. 

So then … WHY am I now being questioned?

An ‘exposé’ was published in NEJM this week by a group of researchers who set out to test my relevance in post-MI mortality risk reduction.

I’ve been part of the gang for years. Up there with the best - antiplatelets, statins, we’ve been a dream team. 

“The Six A’s” med students whisper reverently, as they commit us to lifelong memory. 

I was a black swan. A Beta amongst the chad Alpha ‘As’. But I was respected. I was needed.

Until the SMART-DECISION paper dropped…

Published in NEJM, researchers conducted a randomised, non-inferiority trial at 25 centres across South Korea, involving 2540 patients.

Patients were randomised to 1 of 2 groups:

What did they test me on? 

Follow-up was done after 3.1 years, looking at a composite primary outcome of all-cause mortality, recurrent MI and hospitalisation for heart failure.

And what's the verdict?

The primary outcome occurred in 7.2% (discontinuation) vs 9.0% (continuation). Hazard ratio (HR): 0.80 (95% CI 0.5-1.13), p=0.001.

Ie. Non-inferiority was achieved, and discontinuation did not increase the risk of major adverse cardiovascular events. Ouch.

But hey, even if it was a solid RCT with long-term follow-up, no paper is perfect. 

So do I deserve the negative press? Not quite yet. 

I was never meant to be a one-size-fits-all solution.
I still shine in the right patients: Reduced EF? Tachyarrhythmias? Symptomatic angina? I’ve got you.

But a patient with preserved EF, post-MI, optimised on modern therapy?

Maybe the SMART-DECISION would be to do away with me after all 😔

Once again…
Someone has made the brave decision of entrusting you with sustaining human life. You mostly know what you’re doing. Mostly…

But on those days, when protocol isn’t obvious, the case is complex, and your reg is MIA… who you gunna call?

Ghostbus–... no, no.
Medwise.ai

Imagine if ChatGPT were put in a blender with NICE guidelines, Society Consensus Statement, and Royal College publication.

Mixed into an AI smoothie trained on everything you need in your practice(a slight metallic aftertaste, but you can manage it) 

You type a question and bam:
Instant Evidence-based answers
Accurate. Sharp. Clinically on point. 

It’s used by over 2,000 NHS organisations.
It’s completely free.
If you’re still not convinced, you get free CPD points just for asking questions too!

Start looking dangerously competent on the wards and use Medwise.ai today.
And if you use your NHS email address, you’ll get access completely free.

Try Medwise for free using the link below 👇

Until today, I was blissfully unaware there was so much to be aware of in the month of March. Shame on the marketing departments for failing to do their only job. 

I should be seeing Suffragettes throughout my timeline. 
I should be seeing the NHS Healthy Plate as an Instagram ad instead of Huel and Simmer Eats. 
I should see posters of my Uncle Danny demonstrating the consequences of a Bet365 addiction.

Adding to the irony, this year the theme of Endometriosis Action Month is: ‘Endometriosis doesn’t wait’.

And yet, they waited until the last day of the month to drop a brand new guideline change.

“For years, those with endometriosis have told us they felt invisible within the fertility system – grouped with unexplained infertility despite having a diagnosed condition,” says Chief Executive of Endometriosis UK Emma Cox

So, in order to combat this, Endometriosis now has its own NICE-approved fertility pathway. It’s a “clear treatment pathway” setting out how to manage people trying to get pregnant with the condition. 

The main points are:

That's pretty much it, but just don’t take our word for it. Read it for yourself here.

I’ll do my part in improving this awareness thing for April, so…

Happy Stress-Autism-Parkinson-IBS-Animal-Cruelity-Caesarean awareness month to you all!

I’d love to be a fly on the email thread where these negotiations take place.

It’s surely riddled with all kinds of passive-aggressive corporate speak, like “as per my last email” and “just touching base”

Another round of strikes is taking place next week. As the back and forth between the Government and the BMA has (once again) broken down.

Just so we’re all caught up, here is the lore:

RDC co-chair Dr Jack Flecher went on LBC to voice his thoughts on the matter:

“The way out of this is to sit down and work together to get out of this,” he said.

Getting together over easter weekend to try and hash things out before Tuesday's strikes. I think any man willing to give up his easter chocolate for the greater good of the profession is a man worth hearing out. 

Relevant almost exclusively to the GP Partner readers of The Handover (If you exist, reply to this email saying Hi 👋), the Global Sum Payment – The basic amount the government pay practices per patient – is going up. A 3.5% increase in 2026-27 will lead to the Global Sum Paymen going from £123.34 to £130.07

Which is… okay, I guess. The bigger question is whether the juice is worth the squeeze? The number of partners has reduced by almost 700 since the last general election and doesn’t look like slowing down.

The BMA suggest an increase of £50 per patient to incentivise young GPs to set up their own shops.

A rare medtech story for you:

So… what happens when you take 1 man, AI Slop, and GLP-1 Mimetics and put them into one company? 

A $1.8 Billion Telehealth corporation called Medvi. The darling of Forbes, The New York Times and India Today(the only one without a paywall to read content tbh). A company that simply connects patients on demand to a GLP-1 or peptide of their desire. 

They tell the inspirational story of Matthew Gallagher, a 41-year-old from California. Armed with $20,000, ChatGPT and a dream, he slopped his way to $450 million in his first year of business. 

According to this Twitter user, all but one of the doctors promoting his product… are AI-generated. Add this to FTC warnings for misbranding and an apparent data breach exposing 1.6 million patient records, Medvi’s story sounds a bit more sloppy.

I’m sure it will be fine though… it was covered in Forbes! The Forbes-to-fraud pipeline is very well established now💆

Handover Over 🫡

If you liked it, tell your mates
(forward along, please. It only takes 15 seconds, making this took 15 hours and a rewrite)
If you hated it, tell your enemies.

Before you depart(if you haven’t voted already), please let us know your role in the poll below - It means the world when you do 🫶