Jonathan - I am so sorry to hear of your health issues and wish you well, so good to hear you are being well looked after. I totally agree with the points you make. And how wonderfully positive you sound about general practice - so lovely to hear.
I think I have trouble declaring myself a 'same day emergency' yet also feel too vulnerable and anxious to wait 3-4 weeks for attention for my (very occasional! I promise!) health concerns! I think there is room for both systems - I am so grateful to my GP surgery whenever I do take one of my kids or (rarely) need to go myself and manage to tolerate the wait to be seen. But for me, the extended hours service is a great middle ground option for the things that aren't 'same day' urgent, but would weigh on me for weeks on end if I were to wait.
The last thing I want to do is criticise my unbelievably heroic in-hours GP colleagues. I know how hard they work, I used to be one of them until I bailed out! I couldn't do your/their job. It is heartening to hear how much you have loved your job over such a long time, and hope to continue loving it for a long time to come. Thanks for your comment:-)
You’re probably right. I still don’t seem to be using the right words or phrases when I contact my surgery despite my supposed inside knowledge! I think the truth here is that, deep down, I knew that I wasn’t likely to have a true emergency on my hands, so felt remorse at making a fuss and asking to be seen ‘urgently’. I know that the doctors at my own surgery are *great* when I do see them and this is in no way a slur on them.
Thank you for your kind words! Means such a lot. I am in turn in awe of you all, who (surely!) manage more than one measly session per week in primary care, and are therefore heroes in my eyes!
Thanks for your replies! I have yet to work in the Australian Outback, and can only imagine...I have worked in Brisbane and Perth, but, as you know, you could live in such cities for months at a time without even realising that there IS an Aboriginal presence in the country at all. In Perth I was dealing with hair analysis results, naturopath 'referrals' and whatever the current now ubiquitous 'adrenal fatigue' used to present as in the mid- 2000's - I have thankfully forgotten! But I had friends who did work in Aboriginal health clinics on the city outskirts, and their stories were absolutely hair-raising. Like you, I hope to return Down Under in due course - at least for a chunk of the year. I will forever have my heart divided between the two hemispheres, I think!
UtterFool, here is a link to a reasonably clear explanation of ACC:
It certainly is unique. It is largely a force for good, but getting it to pay out for non-barn-door accidents can be tricky, and there are constant controversies (often featured in the media) over perceived injustices within the system as it currently stands.
Saldoc - do you know, I had kind of forgotten that much doctoring these days in general practice goes on by telephone. This was beaten out of me (okay, not quite literally) in NZ, since it is hard to charge patients for phone time! So the incentive of every practice is to see their patients face to face! I have now managed to conduct some patienting (as opposed to doctoring) by phone pretty successfully. I guess the next step will be signing up to one of the doctor apps as a patient! (JOKE!) (I think!)
Mmh yes the payments are a huge disincentive for people being investigated, that's absolutely true. An ECG at our practice cost $50. Also NZ GPs are poorly paid, compared to their UK counterparts, the job is massively sedentary (you barely leave your room at all, during the day - I HATED that aspect!) and you are a second class citizen compared to your secondary care colleagues, who have a huge study leave budget ($16,000/year) to fly off to overseas conferences with, and are much, much better paid generally. Unless you are a practice owner, it is hard to make comparable money in primary care. But the pace of work is certainly not as insane over there, that's a massive plus! And the country is small, so networking is easy, there are really good conferences and educational events up and down the country, and great peer support groups which meet monthly and are a fantastic source of information and friendship and advice. I haven't even mentioned the infamous ACC! Those of you who have worked in NZ will know all about the byzantine complexity of this system, unique to NZ, which caters to all accidents (even if that's an insect bite!) in order to avoid the all-too-common litigation scenarios common to the rest of the developed world...
I am so touched by your comments - thank you for taking the time to write them. I particularly sympathise with those of you who have also had to go through the hideous experience that is the GMC complaints procedure - and for much longer than Richard, in some cases. The problem is that the effects of such an experience last way beyond the closing of the case, as some of you know to your own personal cost! Rich's confidence in his clinical decisions was never the same again.
I am managing my slightly odd combination of hospice and A&E work so far - and finding huge comfort in the wave of warmth and support that has enveloped me ever since I lost my husband. Circumstances keep pulling me back to general practice, a job I have been trying to escape for years! But the A&E model suits me, and perhaps provides me with a way of staying within the profession for a little longer...