General practice as a career has been shot down by the press and the media. What can be a wonderful rewarding profession has seen so much "evilness" towards it that medical students are likely to encounter the negativity elsewhere. The profession is in difficulty. Speaking as a trainer, I have a duty to promote it but also a duty to be realistic. Primary care needs more resource, better working conditions, less work shifted to us for noting extra and newer models of working. GPs need to be recognised for the work they do day to day and this needs to be reflected in remuneration. Unfortunately the NHS is falling apart and the negativity in the profession has become well and truly engrained in the last few years. Things need to change and fast or you general practice as we know it I.e GPs doing what they do best I.e serving communities in an individual and population level will stop and GPs training now will move abroad and not consider permanent work at all. This is a very dangerous time for general practice and I just hope the government can see that quickly.
Gongs will be awarded to those who probably deserve them the least i suspect. Try a LOT harder Jeremy. GPs need a lot more than gongs at present to boost any sort of morale that is left
I'm not far ahead - 6 years in and can relate to this article although I do feel as though I have become an "expert" in managing risk and uncertainty. Something that underpins the work we do
I wrote an article back in in 2013 on changing the title to primary care consultant....agree we are specialists in a increasingly complex primary care
Being a partner in a well run practice is still fantastically rewarding despite the flood of negative press currently. I have been a partner now 4 years and yes it has downsides but has many more positives and i personally retain my autonomy more than I ever would have in secondary care or as a salaried GP. General practice has the beauty of opening up so many opportunities whether it be partner, Locum, salaried etc etc ( list goes on) Everyone differs as to what their career aspirations or life priorities are and regardless of what they are, there is something in general practice for you!! Yes it's hard at the mo (like with many public sector jobs) but remember that the grass is always greener. I do agree things need to change ASAP and do hope they do but (maybe I'm naive) I also think with all the challenges a lot of opportunity is
Also being generated. I do understand why recruitment is low and people are leaving the profession. I really
hope this changes otherwise what is/has the potential to be such a fascinating job really will disappear in the next 25 years....
How can we benchmark mr hunt...any suggestions?
Surely at some point he will the feel the need to resign...I think he has upset ALL doctors at some level or another. That is a lot of docs.....
Hmmm! Straight to oramorph perhaps or naproxen leading to UGI bleed and AKI. Yes let's stop paracetamol......that evil harmful drug!
Agree with a lot of this. I am a 4 year
old partner, 35 and enjoying the autonomy and flexibility / challenge that it brings that I never had as a salaried gp. Think very carefully though at present as finances are tight. If you opt for a partnership, make sure you go through the accounts with a fine toothcomb to ensure you know what you are getting yourself into. A good strong partnership will be rewarding but get it wrong and you could lose any respect or admiration you have for the profession. At the moment it's not an easy decision so ensure you explore all your options (my advice to new gps)
110% behind you guys. Good luck. Hope you get above and beyond what you want
Truly agree. The only holistic professionals left who truly know are patients. The rubbish that comes with it though is clearly becoming more frustrating. We now have a referral management system in our area that has to approve OUR already made decision to refer and I now need funding approval for things like ganglion and see cysts before they can be excised - The list of these procedures goes on. I agree though wouldn't do anything else in medicine. NHS would crumble without us.
Good work. Potential medico legal nightmare though aswell if goes wrong. Glad went well. Should be proud.
Very useful. Often see diarrhoea investigated in diabetics when metformin hasn't been addressed so crucial to try MR version or temporary cessation before opening the patient up to a whole multitude of risky investigations assuming there are no glaring red flags. Suspect autonomic neuropathy isn't thought to be as common as 1/3rd
Really useful thanks. Would also add metformin in the AKI list with risk of lactic acidosis if cr 150 or eGFR
Rarely use bisacodyl so good to know
Very well written! Felt like the start of a dickens novel ...
Very useful. Thanks
Any extra work at present is very tough! Where does the line get drawn. We are currently coding all our new pre diabetics and providing all the relevant information to them in the hope that this will prevent progression to diabetes. Should we get paid for it? Well a general practice is crumbling as we speak because the morals of most clinicians is abused; as a profession for some reason we find it difficult to say no and the consequences of that are currently speaking for themselves!
Do consultants have to do this? I try and see a silver lining in most things but I am totally lost with this one!