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'One of the biggest things that will kill general practice is GPs'

Resilient GP founder Dr Stephanie De Giorgio speaks about how the profession must stand together to ensure it survives and debates with Professor Clare Gerada about ‘patient blaming’ at Pulse Live

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Readers' comments (55)

  • Totally agree with you Stephanie.

    Clare, you are wrong. We should frequently blame certain patients. You are also wrong if you think that being salaried will sort the problem out. Employers can easily force salaried doctors to see more patients in a shorter period of time without increasing their income

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  • CG pushing her salaried service agenda again - shocker.

    How would a change in job title stop the 6:29 visit request? "Sorry, I clock off at 6:30, bye now..."

    Right...

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  • The only way to sort this out is:

    1. GPs have to be paid per consultation
    2. Patients have to make a co-payment per consultation

    It works everywhere else in the world. The only issue is, why do GPs not want this?

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  • Well done Stephanie!
    Clare if you are so certain that being salaried is the way forward, why don't you lead from the front and accept the same salaried contract you offer your employees?
    Suggesting we all be employees is hardly a surprising attitude from an employer, you may fond your views differ from this side of the equation.

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  • Well done Stephanie for saying it bas it should be said. People with vested interests want a Salaried GP syatem, but would prefer not to take up such a job themselves. Well done also on your comment re ` Patient blaming` ..Yes, some patients do need to be blamed for inappropriate and persistent unnecessary demands etc. Its time we ditched the servile ` The patient is always right` attitude, and what is right for the patient and not what they want. Primary Care in the NHS is indeed doomed otherwise.

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  • Well done! Stephenie De Georgio is right.Demand has to be curbed or else we are doomed!

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  • CG is right, Resilient GP seem to be oblivious to the multiplicity of reasons underlying a patient's decision to consult at any given time.

    Patient bashing may feel therapeutic, but perhaps Resilient GP would better spend its time managing the unrealistic expectations displayed by its own members. Here's a few hints.

    - Patients don't have the benefit of medical training.

    - Patients are not skilled in triage.

    - Patients may experience novel symptoms as worrying due to not having any medical training.

    - Patients when sick, diseased, vulnerable, lonely, anxious or depressed may make decisions that seem irrational to you but are rational from their point of view. People are different - what's trivial to you may be extremely important to a patient.

    - Doctors can't expect to see only patients with rare or exciting diseases. Part of the role of the doctor is to provide reassurance for people who don't have anything serious wrong.

    - The doctor-centred consultation that is so favoured in Britain (think the privileging of scoring QOF points for financial gain over providing patient-centred care) may leave many patients feeling short-changed as their agendas aren't addressed.

    - Patient bashing hits the hardest those who are most vulnerable and in need of NHS help: the "mustn't bother the doctor" elderly, the "I already use too many NHS resources" chronically sick, the poor, the uneducated, the inarticulate and those who struggle with their mental health.

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  • Who has suggested patient bashing? There's a world of difference between "Never blame the patient" and "patient bashing".
    If you can really see no difference then can I suggest your day to day exposure to general practice must be awfully small?
    We all see people who are using the health service inappropriately and we must be allowed to challenge this without fear of central reprisal.

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  • Uh huh, so how would a salaried service change that?

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  • It is absurd that GP partners are of the view that - the Government should spend hundreds and thousands of pounds of the taxpayers money to train medical students at medical school and then in the hospitals - and once qualified as as a GP, these newly qualified should all become Salaried GPs working hard for GP partners only,and ensuring that the GP partners make maximum profit for their business while at the same time most (not all) partners become SEMI-RETIRED (part-time) even before the age of 40.

    The simple solution would be the Australian system where :

    1. All GPs are independent practitioners
    2. They are paid per consultation.
    3. The GPs then pay the owner of a building that is being used as a surgery a percentage of the billing (currently in Australia it is something like 30% of the billing is paid to the building owners/managers)


    This will ensure that all GPs will have to work an appropriate number hours and SEE PATIENTS to make a living.

    This is ensure that access to patients is improved because all GPs (including those who are already or wanting to become SEMI-RETIRED before even reaching the age of 40) will have to be available to see patients to make a living.

    This will ensure that GPs treat patients with respect - because if you treat patients badly -( unlike the current system where payment to bad and lazy GPs is still guaranteed as patients have little choice ) - the patients will never ever bother to see such GPs - which would in turn affect the GP earnings.

    All these measures would ensure -
    1. Improved access to patients
    2. Increase competition between GPs
    3. Improved care to patients by the GPs
    4. Minimize abuse of the current system by those who are already privileged to be semi-retired / partners / etc.

    IF WE CONTINUE TO PROPAGATE THE CONCEPT OF ALL BECOMING SALARIED - IT IS TOTALLY AND UTTERLY REPULSIVE TO ANYONE WHO IS CONSIDERING TO PURSUE A GP CAREER.

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