This site is intended for health professionals only

At the heart of general practice since 1960

pul jul aug2020 cover 80x101px
Read the latest issue online

Independents' Day

Dr Amy Small: 'I felt like I was drowning'

Dr Amy Small describes how burnout affected her working life and how she feels now after going part-time.

I went part time in January because I was burning out.

I started to recognise I was spending less and less time with patients. I was worried the more time I spent with patients the more problems they’d tell me and the more work I’d have.

I felt like I was drowning. Every day I was getting up, going to work and hating it. I was there from 8am to 8pm and I was struggling. It was never ending. Knowing it would be the same every day and that I’d have to get up the next day to come back made it difficult to cope.

During consultations I would cut patients off when they were speaking. They would come in and I would see three or four yellow QOF boxes to tick. I was always hoping I didn’t generate a referral. I was curt with patients, I was always rushing, going on home visits but not delving into complex issues.

A patient saw me and I’d focus on the issue at hand but not go into other problems - which you should for holistic, all round care. I wasn’t sleeping properly, I felt stressed all the time. Friends would say I looked tired. Now I’ve gone part time people tell me ‘you look so much better’.

I’d talked to colleagues quite a bit about it in November, before I was due to go on holiday. I said that when I got back I couldn’t work at the same pace. I felt guilty about having to cut down, because it would increase the other partners’ workload, but I couldn’t go on.

Since January I’ve been working six sessions and I catch up on things in a few hours on other days. I feel so much better. I’m enjoying my work. Only going to have to see patients three times a week so I can still enjoy that time without the drowning feeling. Today is a day off but I’ve just been doing all the admin.

Definitely think we’re seeing the effects locally. We don’t have enough applicants for advertised posts. When I applied for a job three years ago I think there were 40 candidates, two years ago and only 10 applicants. People don’t want to become full-time partners anymore. We’re not filling trainee numbers, we’re not filling partnerships.

The Government are shooting from any which way at us, and they don’t care about the burnout at all. You can see by the contract imposition in England, pension reforms, practices now paying locum pensions contributions.

They don’t realise GPs are going to end up making mistakes, they’re going to end up quitting or if they do, they frankly don’t care. There are fewer full-partners coming in, therefore they are relying on doing the work with locums. My big fear is that the private companies will come in and hire a workforce of salaried GPs and what will that do for patients?

Dr Amy Small, is a GPC member and GP in Lothian

Readers' comments (7)

  • Painfully honest, painfully true. Anything more than 7 sessions in partnership is becoming untenable.

    Unsuitable or offensive? Report this comment

  • Thank you for having the courage to be open and honest with yourself, your partners and others in our profession. I admire you and think you have made a lot of other people who feel the same way feel better. Maybe they will now have the courage to change things for the better for themselves and be better understood by their colleagues.
    Good luck!

    Unsuitable or offensive? Report this comment

  • Thank you Amy for the courage to say what many of us have experienced. There is a "perfect storm" in general practice to the detriment of both patients and doctors health. This cannot go on. Even some GPs are oblivious to it all and how they are not helping themselves or colleagues with self-imposed pressures as well. During this turbulent time I am glad to be a Freelance GP, making a worthwhile contribution primarily to patient care without all the distractions. The General Practice "landscape" I am witnessing from a locum's perspective is very concerning indeed.

    Unsuitable or offensive? Report this comment

  • My impression is that the GPs who are most likely to burn out are those who have the Messiah complex especially in their early years when they're still green and very naive about life.In trying to save humanity they end up being crucified on the cross

    Unsuitable or offensive? Report this comment

  • Well done for sharing your experience. Yes, private companies coming in and taking over general practice are a real danger to both patients and GPs! They work on metrics, not patient need. They take advantage of our professionalism, so let us carry the can and happily ignore our extra efforts, yet focus on the cost alone of staff, rather than what is needed to ensure safe patient care.
    I've carried a practice for over a year, put in extra hours to make sure everything is up-to-date, but never received a bonus or increase in my salary to reflect my contribution. More workload is piled on, I deal with non-clinical managers not based at the surgery who interfere and undermine the clinical team.
    Is it any wonder general practice is going to pot due to private companies? GPs don't stay as they are undervalued and treated with disrespect, the reliance on locums creates issues in terms of continuity and more work for regular GPs (while/if they stay at the practice), practice managers come and go, staff are on edge the whole time, all the while the company is flogging the staff while staring at their spreadsheets!

    Unsuitable or offensive? Report this comment

  • What a brave and honest account. I whole heatedly agree with your comments and understand how you felt. I am glad you are so much happier now, and are able to be the doctor you want to be.

    Unsuitable or offensive? Report this comment

  • Secure environments GP

    I would say that self-imposed perfectionism with such heavy workloads puts us all at risk of burnout. We cannot do all things for all people. Sometimes a "good enough" job has to be done, that spreads our energy across the day and leaves some positive emotions and energy left for our home life. The solution may well end up being an imperative for a new contract which will re-engage and attract new GPs. I think it is getting untenable with the levels of medical complexity and a risk-adverse culture for us to remain offering 10 min appts. It will soon have to be 15 mins or we will be at further risk of burnout and inevitable mistakes with the potential to wreck patients and doctors lives.

    Unsuitable or offensive? Report this comment

Have your say