14 Jan Is it worth the bother?
“Why bother with this?” That is the question a lot of us GPs seem to be asking at the moment. Reading this article alone may take 5 minutes, and at the end, you may wonder why you bothered. This is a thought that often fills my mind these days. Is it worth it? Where is the corner that could be cut? This is the result of an over busy day and a mind that has already made too many decisions.
So you will find many GPs writing to bemoan this fact, and to extol upon others the stress we are facing. How is it worth going through this every day if we don’t get some credit for it? But I am not going to do that. I fear that this way of thinking is negative and destructive to our very profession.
The many advantages of general practice
I have been a GP barely 2 years. I am, as many patients point out, fresh faced. I have some advantages in assessing the situation in General Practice at the moment over those older GPs who have been at it much longer. Mainly, I have more recently experienced the hand of medicine elsewhere in the system, and I can see where general practice holds its trump cards. The best possible card we have is the relationship with our patients.
A well-frequented online group for GPs recently featured a photo of a consulting room door. In bold capitals it read, ‘10 minutes, one patient, one problem’ – a plea for an easier consultation to any patient about to enter from an over-worked and overstressed clinician. A discussion then followed about the nature of medical presentations and the apparently unconnected symptoms that may indicate an underlying condition. For me the greatest concern was the way that a poster like that would make my patients feel. Reading such sign, as a patient, I would feel unable to talk freely, that this was not a kind space, and that this was therefore not a therapeutic relationship. Preserving which, should be at the core of what we do.
But other cards we hold are the more independent nature of our practice (change being easy and swift – as opposed to the bureaucracy of secondary care) and the special abilities of a generalist to treat a patient holistically above a ‘limited scope practitioner’ (more commonly, but wrongly called a specialist).
So, I think, that what may actually improve our lives, our stress levels and even our abilities as doctors is to take a step back and congratulate ourselves a little bit.
Sounds a little sanctimonious, I fully realize. But as I alluded to earlier, nobody else seems all that inclined to congratulate us at the moment, so what the hell? I think the best way of doing this is to speak to your colleagues. I have worked in several practices, but only in one of them have the GPs sat down to eat lunch together every day. And it is only in this luncheon sharing practice where I felt part of a team rather than alone, and only there I felt that I am not taking all my stress home with me every day.
Don’t ignore the positives
I think sometimes, we don’t notice the good things we are doing for all the moaning about the things we could do better. All those 60 patients you spoke to yesterday were probably left somehow better off. So, much as we complain, and see that all we have built seems to crumble around us as the powers in the land see fit, let us remember that what we have is worth a lot. It is worth fighting for, and mostly worth the bother. We just need to remind ourselves of this now and then.
I am currently a GP partner in Llangollen, North Wales, and have been so for just over a year. Prior to this, I worked as a salaried GP and as a locum at several other practices in North Wales.
I completed my GP training in 2014, on the Wrexham training scheme. Prior to this, as a junior doctor, I had worked in Cairns, Australia for a couple of years in emergency medicine before returning to the UK to become a GP. I trained in Cardiff, where I also completed an additional degree in psychology, as an ‘intercalated’ year on the medical course.
My interests these days are more to do with diet and lifestyle. I took over as diabetes lead in my current practice, and have been working locally on low carb diet groups for patients.
I have had a few political inclinations – having been on the RCGP council as a trainee. I am also a member of the college ‘overdiagnosis group’.
I spend a lot of my spare time reading Medieval History books and playing in a jazz band.