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Commissioners and politicians, be warned: GPs work best when they're not stressed

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This year promises to be a critical one for general practice as we grasp the commissioning reins. Along with this massive responsibility, we face the likelihood of a harsh contract imposition.

However, most of us know that week in week out, come rain or shine we'll be there in our surgeries, delivering the best care we're capable of.

Like most GPs, I plan to approach the measures that are not in my patients' interests in a tick-box fashion, depending on the level of remuneration available.

Our practice has always exercised the option of not doing work that feels inadequately resourced, or which is not for the benefit of our patients. Measures which are sensible and reasonable will be embraced and applied, at least in a workmanlike way if not with outright enthusiasm.

Ultimately as a group we GPs know what's good for our wellbeing. Even the hard-nosed cynic recognises that delivering good care makes for job satisfaction, better self esteem, health and happiness.

Over the uneven course of years as a GP partner, I have come to realise that if I'm tired, stressed, unwell or in physical or mental pain I tend to refer more, prescribe more and have a slightly lower threshold for admitting challenging cases. When I'm fit and well, all these parameters improve and I have greater resources for the job. I make no apologies for this because it's simply human nature.

But the focus on GPs as commissioners has brought this variation into sharper focus, thanks to  endless scrutiny of activities such as making referrals.

The challenge for the coming year and years to come is, for all GPs, to look after their bodies and minds sufficiently well despite the climate of adversity. I take my responsibility for keeping well quite seriously and a big part of keeping this balance is being discerning where to focus my energies and efforts.

As a GP I want to be motivated beyond the tick box mentality and to feel that everything I do is genuinely worthwhile. If CCGs can harness our motivation they will find many things possible in their efforts to create new pathways, improve quality and find efficiency savings along the way.

Dr Andy Field is a GP in York. He is also a member of North Yorkshire LMC but this article does not reflect the views of the LMC.

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