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Gold, incentives and meh

General practice is a joke that just isn’t funny anymore

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There was a time was when these blogs would relate hilarious (well, I thought so) episodes from the wacky world of general practice. But, while there’s still the occasional smirk-worthy moment (e.g. the fact that, in the last three months, we’ve had a grand total of one Friends and Family Test questionnaire returned, and that was blank), it’s getting increasingly difficult to introduce any levity on account of GP land being so frankly crap. As a result, our cerebral LOL centres have atrophied, and it’s no longer possible to shrug off the grind of general practice with a wry smile.

We’ve gone beyond being buoyed by stunt politics and instead want real solutions

Which probably explains my reaction to the proposal that all GPs should immediately be signed off work with stress. This is a motion apparently proposed by Shropshire LMC, which could be debated at the LMCs conference this month.

Once, I’d have found this hilarious – not least because, as one reader has commented, who will sign GPs off with stress if all GPs are signed off with stress? But I don’t find it hilarious now, though. Yes, it’s clever, quirky and eye-catching. But the parlous state of general practice means we’ve gone beyond being buoyed by stunt politics and instead want real solutions. We thought the much trumpeted Forward View might offer some: a grand gesture or two, perhaps, which would have been instantly transformative. Instead, we received small pots of jam tomorrow, half promises with strings attached, which just add to the frustration rather than alleviate it.

And so, in the absence of those grand gestures, the LMCs are resorting to empty ones in an attempt to raise a smile or some publicity. I doubt it’ll do either. General practice is a joke that just isn’t funny anymore.

Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield

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Readers' comments (20)

  • Made my day. Just had a look at the heading this morning and had good laugh after a long time. It's funny that it's not funny anymore:)

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  • Russell Thorpe

    The view from the top of the wave. Just 7 patients booked in this morning.

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  • How much time have you got?
    All these politician jerks need to do is to trust us. We know what we're doing, they patently don't!
    Put a proper doctor in charge at Richmond House, chuck out the dross,
    Move the NHS out of the political arena and fund it via the NI contribution.
    The Royal Colleges can direct clinical trends and quality and the Department of Medical Economics at York University can predict trends and future costs.
    Simple, if only they trusted us!!

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  • I have just had the pleasure of hearing someone expert than me frame the challenge who comes from a non NHS background

    In a system where there is complexity and complicated solutions you should reduce the complicated solutions to a minimum and embrace complexity, the latter supported by a few simple principles and rules.

    With simple rules in place you can allow freedoms to become the majority with controls to become th4 minority

    The future of General Practice if anyone "in power" is willing to hear is
    BE BRAVE
    LET GO
    BE COMPASSIONATE
    EMBRACE THE COMPLEXITY
    REDUCE THE COMPLICATED
    STOP REACTING TO SINGLE EVENTS
    ESTABLISH SOME SIMPLE RULES
    REDUCE CONTROLS
    INCREASE FREEDOMS

    I dunno.... ?
    Might be worth a try?
    Wake up
    P;)

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  • I would not be a GP in this UK if I had a choice. I would not be a doctor here either.
    You just finish an 80 hour weekend with 3 hours sleep at 30p an hour and there it an editorial in a leading newspaper of how powerful the BMA is, how overpaid and lazy doctors are. And that was 30 years ago.
    No change then.
    I suppose there will always be young people wanting to be doctors, no matter imposed Contracts, 13-14 hour days, CQC, GMC etc, litigation etc.I wish I could speak to them the horror that awaits but they have no idea.
    The DOH and the nation is counting on that.

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  • I used to be the lead partner in an "all singing and dancing" practice which innovated and grew very quickly. We had big plans, fuelled by a CCG who said they wanted us to invest but never came thru with the support they gushed. Our CCG failed and is now under special measures for failing to support primary care. I now work 8 sessions across 2 very calm practices as a sessional GP. It is great fun again. Clinical work is great. One of my sessional colleagues gave me good advice. "Start each day with the acceptance that the NHS is broken beyond repair, not your fault and will end soon. Do your own good work and don't worry about the system".
    Luvly.

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  • We are an illustrious profession but we have stopped being professionals
    My rule of R's for each consultation is :
    Rapport and relax the patient
    Rigorous clinical medicine leave no stone unturned
    Relevant investigations
    Relate to the patients anxieties why have they come etc
    Review your opinion with the patient inviting comeback
    "road map" what is going to happen tests etc and discuss outcomes etc
    Record it
    All in 6 minutes !! What a joke gave up years ago

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  • David Hogg

    Teaching can be fun. And I've learned from our medical students that many see general practice as a worldwide opportunity, not just UK NHS. They can focus and look forward to an international career if they wish, and let their attraction to UK work be dictated by market forces at the time.

    Have we become too insular as a profession here? Too much ePortfolio, tickbox-checking and slaves to paperwork demands. The fun of GP is quickly lost when our attention is on the computer and not the patient. We might benefit from seeing ourselves on the international GP stage as we have much to learn, share and laugh about with others - Dutch and South African GPs seem to retain the humour of our profession particularly well!

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  • Everyone says how gen prac is an international career.. Not really you still have the hassle of getting each different countries exams first then visa issues etc Then the local cultural and payment methods issues ...
    I feel like the musicians on the titanic ..
    just keep playing on
    and go down with the ship...

    Is the glass nearly empty
    or is there one last glug
    lets enjoy the last glug
    we and the patients will miss these days of reasonable freedom to provide the best care to everyone
    cheers

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  • Whata that quote in that golfing movie Bagger vance ... I play on for the moments that are yet to come ..

    There are always moments where you make a difference Where someone is really appreciative .. makes it all worthwhile

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From: Copperfield

Dr Tony Copperfield is a jobbing GP in Essex with more than a few chips on his shoulder