Dr Louella Vaughan
@drlkvaughan.bsky.social
Consultant Acute Physician, The Royal London. Health policy nerd. Former Harveian Librarian, RCP. Antipodean. Views own.
Interesting piece Helen!
August 21, 2025 at 4:30 PM
Interesting piece Helen!
Sadly, you are probably right.
To be subdivided and flogged for apartment blocks.
To be subdivided and flogged for apartment blocks.
August 1, 2025 at 1:24 PM
Sadly, you are probably right.
To be subdivided and flogged for apartment blocks.
To be subdivided and flogged for apartment blocks.
Lovely! Lucky you.
August 1, 2025 at 1:19 PM
Lovely! Lucky you.
Buffy the Vampire Slayer.
a woman with red hair is asking " who asked you " what are you talking about
ALT: a woman with red hair is asking " who asked you " what are you talking about
media.tenor.com
August 1, 2025 at 1:19 PM
Buffy the Vampire Slayer.
Australian 3/4 acre block outer suburbs...
August 1, 2025 at 1:17 PM
Australian 3/4 acre block outer suburbs...
Andy, this topic is MUCH more fun over on Twitter.
Everyone on Bluesky is too polite.
Everyone on Bluesky is too polite.
July 10, 2025 at 10:53 AM
Andy, this topic is MUCH more fun over on Twitter.
Everyone on Bluesky is too polite.
Everyone on Bluesky is too polite.
Me after reading the 10YP.
a baby girl is sitting on a couch with her eyes closed and making a funny face .
ALT: a baby girl is sitting on a couch with her eyes closed and making a funny face .
media.tenor.com
July 10, 2025 at 10:48 AM
Me after reading the 10YP.
I am so very sorry Trisha.
She was a very lovely one.
She was a very lovely one.
April 19, 2025 at 1:26 PM
I am so very sorry Trisha.
She was a very lovely one.
She was a very lovely one.
Thanks both!
Claudia and I found it a very difficult piece of work to do. But was important to document experiences and analyze impact soon after events.
Organisations have VERY short memories.
Claudia and I found it a very difficult piece of work to do. But was important to document experiences and analyze impact soon after events.
Organisations have VERY short memories.
April 8, 2025 at 10:30 AM
Thanks both!
Claudia and I found it a very difficult piece of work to do. But was important to document experiences and analyze impact soon after events.
Organisations have VERY short memories.
Claudia and I found it a very difficult piece of work to do. But was important to document experiences and analyze impact soon after events.
Organisations have VERY short memories.
Thanks Fiona!
The algorithm threw you up in my timeline on pretty much my first day on Twitter.
I thought: Oh Cool. Interesting stuff. And followed you.
Here we are, a decade later...
The algorithm threw you up in my timeline on pretty much my first day on Twitter.
I thought: Oh Cool. Interesting stuff. And followed you.
Here we are, a decade later...
April 2, 2025 at 9:19 AM
Thanks Fiona!
The algorithm threw you up in my timeline on pretty much my first day on Twitter.
I thought: Oh Cool. Interesting stuff. And followed you.
Here we are, a decade later...
The algorithm threw you up in my timeline on pretty much my first day on Twitter.
I thought: Oh Cool. Interesting stuff. And followed you.
Here we are, a decade later...
Governments around the world need to face up to the issue that the cost of providing healthcare over the next 2 decades is going to be wildly expensive.
Making the workforce less skilled and less efficient for marginal cost savings isn't the solution.
Fin
Making the workforce less skilled and less efficient for marginal cost savings isn't the solution.
Fin
April 1, 2025 at 1:45 PM
Governments around the world need to face up to the issue that the cost of providing healthcare over the next 2 decades is going to be wildly expensive.
Making the workforce less skilled and less efficient for marginal cost savings isn't the solution.
Fin
Making the workforce less skilled and less efficient for marginal cost savings isn't the solution.
Fin
half a century. Fully trained doctors provide the best care. It just isn't possible to chunk up the job and outsource it.
Not is it just not efficient in the long run, but it creates other problems. And patients suffer as a consequence.
5/
Not is it just not efficient in the long run, but it creates other problems. And patients suffer as a consequence.
5/
April 1, 2025 at 1:45 PM
half a century. Fully trained doctors provide the best care. It just isn't possible to chunk up the job and outsource it.
Not is it just not efficient in the long run, but it creates other problems. And patients suffer as a consequence.
5/
Not is it just not efficient in the long run, but it creates other problems. And patients suffer as a consequence.
5/
How do you make one?
How do you ensure safety and accountability?
Especially problematic given that what doctors do (mostly) is to THINK about things and make DECISIONS. The skill stuff is an added extra.
The grand experiment with workforce subs has been going on for over
4/
How do you ensure safety and accountability?
Especially problematic given that what doctors do (mostly) is to THINK about things and make DECISIONS. The skill stuff is an added extra.
The grand experiment with workforce subs has been going on for over
4/
April 1, 2025 at 1:45 PM
How do you make one?
How do you ensure safety and accountability?
Especially problematic given that what doctors do (mostly) is to THINK about things and make DECISIONS. The skill stuff is an added extra.
The grand experiment with workforce subs has been going on for over
4/
How do you ensure safety and accountability?
Especially problematic given that what doctors do (mostly) is to THINK about things and make DECISIONS. The skill stuff is an added extra.
The grand experiment with workforce subs has been going on for over
4/
that not everything a doctor does need years of training. And somethings could (and have been been) be safely done by someone not a doctor.
But the problem is that workforce substitution quickly slides into the existential:
What is a doctor?
What do they do?
3/
But the problem is that workforce substitution quickly slides into the existential:
What is a doctor?
What do they do?
3/
April 1, 2025 at 1:45 PM
that not everything a doctor does need years of training. And somethings could (and have been been) be safely done by someone not a doctor.
But the problem is that workforce substitution quickly slides into the existential:
What is a doctor?
What do they do?
3/
But the problem is that workforce substitution quickly slides into the existential:
What is a doctor?
What do they do?
3/
anywhere in the world. Except perhaps Germany.
The logical solution is train more doctors and to use carrots (+ the occasional stick). But this is expensive!
So the alternative, since the 1960s, has been workforce substitution. This is attractive, as it certainly is true
2/
The logical solution is train more doctors and to use carrots (+ the occasional stick). But this is expensive!
So the alternative, since the 1960s, has been workforce substitution. This is attractive, as it certainly is true
2/
April 1, 2025 at 1:45 PM
anywhere in the world. Except perhaps Germany.
The logical solution is train more doctors and to use carrots (+ the occasional stick). But this is expensive!
So the alternative, since the 1960s, has been workforce substitution. This is attractive, as it certainly is true
2/
The logical solution is train more doctors and to use carrots (+ the occasional stick). But this is expensive!
So the alternative, since the 1960s, has been workforce substitution. This is attractive, as it certainly is true
2/