Luke Koupparis

Medical editor, OnMedica
  • OnMedica
  • United Kingdom

About Luke Koupparis

I am a GP in the Bristol area and also am a medical contributor for OnMedica. I am interested in CPD learning especially online medical education. 


I am a practising General Practitioner, in the UK.

Main area of expertise

General Practice

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Recent Conversations

Recent Comments

Mar 08, 2022

An excellent and timely summary. Thank you for this. 

Mar 08, 2022
Replying to John A Bruton

We have a shortage of GPs which is projected to increase. How can a six day working week with twelve hour day in the week and 8 hour on Saturday solve this . It  is likely to scupper recruitment yand demoralise an already  jaded workforce even more . Patients currently think we work excessive hours just trying to cope with our current workload. We all know work doesn't stop when the last patient leaves. 

I completely agree John. We have a workforce crisis at all levels of general practice at present and the demand is the highest I have seen in my working career. Spreading ourselves over an extended period is not the answer to help a demoralised workforce. I wonder if they have thought about the support services like blood pick ups that will also be required for these extended hours? I doubt it.

Jan 18, 2022

Regarding the following statement: "The guideline calls for non-specialists who have provided initial care to organise a comprehensive psycho-social assessment, at the earliest opportunity after an episode of self-harm, and that this should be carried out by a specialist mental health professional."

I would value further clarification on what is mean by "at earliest opportunity"- thresholds for referral to specialist mental health services prevent this from happening in many cases.  Hopefully it will be possible to quote these NICE guidelines in order to get patients seen swiftly once the final version is released. 

Sep 22, 2021
Replying to Graham McMillan

Unfortunately the pandemic isn't over. Returning to a pre-pandemic system of full waiting rooms will simply put patients and staff at increased risk of disease transmission. We all seem to be forgetting why the system changed in the first place. The benefits and risks of the new system need evaluating carefully. We may be missing some cancers but how many lives are we saving by not sitting elderly patients next to children with influenza?

Agreed Graham- I think the days of putting people at risk by crowding them into waiting rooms must be over. Maybe there is a middle ground and when the dust settles on this we may find it (if general practice still exists!). 

Sep 14, 2021
Replying to Caroline Ann Donoghue

No mention of the A&E staff not x-raying NOF?? 

Does this coroner have something against GPs??

I completely agree with you on this. The link that these were all related to GPs not seeing patients is weak. Other providers don't seem to come in for any criticism which seems odd. 

Aug 10, 2021
Replying to OKON EDEKE

What are the contraindications to PPI use?

In answer to your question, generally they should not be used if there is any known allergy or hypersensitivity to the drug as a starting point (usually quite rare though). In addition it is generally advised that they should not be used prior to an endoscopy in a patient with red flag symptoms as they may mask the symptoms of a GI malignancy.

PPIs undergo metabolism by the cytochrome P450 system of the liver, mostly by CYP2C19; hence, any severe dysfunction in this metabolization serves as a relative contraindication (but many still use them with enhanced monitoring). 

Caution is advised in those patients who are at risk of osteoporosis and in people at risk of hypomagnesaemia (as outlined above). It is important to consider drug interactions as well as outlined in the links above. 

Apr 27, 2021

Chris, your blog is very timely and clearly reflects the mood of general practice at present. As a practice we thought this was just us that were being deluged with these but I read that this is a national issue with people absolutely drowning in econsults. I would be interested to hear how others are looking to manage these over and above switching them off when they are closed. 

Apr 13, 2021

This is interesting from

CV vaccines and blood clot risks:

AZ vaccine: 4 in 1 million (0.0004%)
Oral contraceptive: 900 in 1 million (0.09%)
Average Canadian: 1290 in 1 million (0.13%)
Hospitalised CV patient: 147000 in 1 million (14.7%)