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At the heart of general practice since 1960

Columnist: Andy Jones

No Sugar sweetens this pill

A lot has been made of medical training and curriculum development by educationalists in recent times. We have seen undergraduate and postgraduate schemes changed beyond recognition, with an increase in vocational focus. Yet it is difficult to see how the skills of the next generation will be put to use in an NHS of contestability and commissioned markets.

Assuming you are not a trainee, do you ever wonder which skills from medical school you use most? Practically none is probably the answer. The art of communication is often learned on the job, and textbook medicine is nothing like medicine in real life.

The wider media and the world at large perceive GPs to be cutting-edge entrepreneurs. Rumour that we all take home £250,000 is attracting interest from aspiring medical students to business strategists. The reality is that most GPs run successful small businesses by providing good-quality care.

Until recently our lives have been quite simple and we have been insulated from market forces. But now we are confronted by tenders for care, commissioning care pathways and performance management. Everything is tougher.

While our juniors are learning about communication and unmet patient needs, we are being asked to create tomorrow while managing today. This is not what many GPs will have signed up to do.

As the famous 5 per cent shift takes place from secondary to primary care, it is becoming apparent that traditional medical skills may need to be updated into the language of modern business.

In the eyes of patients, the best doctors undoubtedly have first-class communication skills coupled with disease understanding. But as you go down the list of desired medical attributes you get further away from the things that will drive a successful practice.

Success in the new world will depend on engagement, data analysis and managing change. Engagement presumably ranges from having coffee with colleagues to empathising with every type of patient.

Analysis and assessment of data will involve learning how to interpret and manipulate spreadsheets. We are going to need some powerful but idiot-proof data tools to help us, because online guides are like reading how to ride a bike.

Finally, negotiating the hard-sell will complete our new skill set, persuading all and sundry to alter their approach to contemporary practice.

In educational speak it could be time to identify a few unmet doctor needs; that's yet another communication update, a computer course and an MBA in health care management for every reader.

It has dawned on me that for the new NHS to be successful we are all going to have to apply to Sir Alan Sugar to become his apprentices. Failing that we could just appoint him as the new chief executive, stick to doctoring and wait for redundancy and the contemptuous cry of 'You're fired'.

Dr Andy Jones is a GP in Stamford, Lincolnshire

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