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At the heart of general practice since 1960

1930: A new IT system, a suspect skin lesion - and far too many testicular problems

It's all in a day's work for Halifax GP Dr Asad Mubarik.

It's all in a day's work for Halifax GP Dr Asad Mubarik.

Ahhhhhh 6am already! Monday mornings are always the hardest time to get out of bed, although today the sun is shining through the curtains which almost makes getting up easier (almost).

I jump out of bed - well, drag myself out of bed - after my alarm has been ringing for over ten minutes and rush around getting ready for work.

I'm out of the door before seven and get to work by twenty past. I love going to work when the sun is out and it's daylight. It always gives me a boost for the rest of the day. Roll on summer - I can't wait.

Unfortunately I'm not looking forward to this week at all. We are finally letting the local PCT twist our arms and change our computer system to SystmOne and this is due to happen this Wednesday.

Having a new computer system several weeks before the end of the QOF year adds another element of potential disaster - although anything has to be better then the snail's pace and frequent crashes of our current system. It should be a fun week...

The large piles of paperwork on my desk left from the week before makes me sigh as I walk through the door. I seem to be doing more and more paperwork these days.

I start my surgery at eight and leave my formidable pile of paperwork for 'later'. It seem to be fractionally smaller. But only just.

All the available appointments seem to have disappeared within five minutes of the phones switching over from the local out-of-hours service, so I'm very glad that I'm not the on-call doctor today. Mondays are always the craziest, most hectic day of the week.

I love seeing patients and love the variety you get in general practice. This morning is no exception and during my surgery I see a child with a limp, several cases of depression, a new onset of probable cardiac chest pain, a young man with knee pain, a Bell's palsy, a gentleman with altered bowel habit, far too many people with testicular problems (one of the perils of being the young male partner in a big practice), a gentleman with erectile dysfunction and several rashes. What other speciality lets you see so much variety?

My next patient makes me smile. He had seen a consultant urologist the Friday before, who had noticed a skin lesion on his abdomen.

'He told me to go straight to see my GP, doc.'

In fact the urologist had told the patient not to go home, but to go straight to see the GP from his clinic appointment.

'I got here at 7pm doc, but you were already closed,' he said with a aggrieved look on his face. 'I had a dreadful weekend worrying about it and I almost went to A+E to get it sorted out.'

'How long has it been there?' I asked.

'About ten years' was the reply.

'Has it changed over this time?' was met with a shake of the head as he lifted his top to show me a seborrheic keratosis.

After suitable reassurance and advice with respect to the danger sign to look out for in skin lesions, and the offer to book him in for removal, he was on his way a much happier man.

This case highlights the beauty of general practice. As hospital doctors become more and more sub-specialised, the unique skills a GP has to offer are essential to stop the NHS grinding to a halt. This is why I love general practice, and love the variety and challenges it offers. No surgery is ever the same.

My surgery is just about over by eleven thirty and I am just about to start my telephone consultations when there is a knock on the door. One of the receptionists is stood there with a prescription query, and I can see one of the healthcare assistants clutching an ECG, and a district nurse hovering behind her. I usher them all in and deal with their queries.

All finished by half twelve, and I climb upstairs to see what horrors the visit request book holds. A quick chat with the other partners over coffee, and the visits are distributed before we rush out and rush back for evening surgery so it can all start again.

Food is often an after-thought, and I have a secret chocolate stash that gets me through the day (although I am trying to convert this into a fruit stash).

Finally the day is finished by half seven. The paperwork pile seemingly the same size as this morning, as if the day had never happened.

I sneak home as night closes in.

Dr Asad Mubarik

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