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At the heart of general practice since 1960

How might general practice look in 2050?

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For many practices, planning more than one month ahead is impossible at the moment.

With the current pressures on the service, many doubt whether their practice can survive the next five years and accountants’ predictions for earnings over the next year make sobering reading.

Against that backdrop, I realise it may – at first glance – seem a little naive to start a discussion about what the profession may look like in 2050. But that is what we are kicking off this week in Pulse.

Why? Because at a time of stress, it is tempting to drop anchor, batten down the hatches and wait for the storm to pass. General practice feels buffeted from all sides at the moment so the profession’s instinct may be to narrow, rather than widen, its horizons.

And with good reason. Successive governments have seemed to do their utmost to undermine the profession, at times actively participating in its denigration and maligning its place in the NHS. Systematic underfunding and a failure to plan adequately for the future has resulted in a major crisis of workload and morale in general practice. Something that may take years to heal, even if there is the political will to reverse it.

But there has to be a future for the profession. The relationship GPs have with their patients continues to be the most popular part of the NHS, according to 2014 figures published by the King’s Fund, and is acknowledged by all but the most cynical as the bedrock of the whole system. Yet the UK population is surviving longer and in the future patients will present with more complex, long-term conditions that require sophisticated management and support in the community. Something has to bridge that gap.

So we asked a group of GPs and other experts to speculate on what the service might look like in 2050. We wanted a glimpse of the prospects for medicine, practice premises and being a generalist doctor in 35 years’ time.

Far from predicting Armageddon, many came up with inspired applications for technology that is being developed now. The ideas range from the increasing use of avatars to the rise of personalised care guided by genomic medicine. It shows that, given adequate resources and the headroom to think laterally, there is plenty of enthusiasm for strengthening general practice and developing new ways to interact with patients and improve patient care.

And in all the responses we received, one thing rang clear amid the whizz-bang solutions. An unshakeable principle that will remain at the heart of general practice even in 35 years’ time. Everyone agreed that nothing can replace the time-honoured face-to-face GP consultation as the central pillar of how patients access the NHS and discuss their diagnosis and treatment. And that – in this time of great uncertainty – must be a good sign.

Nigel Praities is editor of Pulse

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Readers' comments (8)

  • Yes but how many people need to die/leave/giveup before we are really appreciated or supported?
    Answer - should be none

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  • "personalised care guided by genomic medicine"

    Sounds like an extension of our current risk factor management work to me.

    If the future is going to be using genetics for more screening, more targeted health promotion, increased preventative intervention and less time to deal with the actual problems patients already have then I can't say it's a vision that would inspire me.

    After all, who ever applied for medical school driven by a passion for assessing statistical risk?

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  • I predict that advances in artificial intelligence and robotics will radically change medicine in 50yrs. We will rely on AI for improved diagnosis and some physical care may be delivered by the likes of Hondas Asimo whilst many operations will be done better by machinery and better targeted medicines will ensure we live to around 120yrs old. There will still be a role for the GP who can empathise and interpret the subtleties of the human condition but technical work will be a thing of the past.

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  • I wonder which of us working today will be the last doctor alive who can talk to and examine a patient, reach a diagnosis, and solve the problem that they presented with.

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  • These are some very interesting views, my concern is for compassion, personal care and human kindness. As our populations grow older and they lose family and communities around them, they become more isolated and lonely. My worry is that we then develop more remote applications to manage their care with no/or limited human contact. Telehealth is a typical example, we might record a persons vital signs through machines from a distance, but we can't reassure them when they are breathless and anxious. I truly believe that technology has its place, but this should not be at the expense of human contact, particularly for the more frail, vulnerable and isolated in our communities. many of the patients who come to my practice to see their GP because they are lonely and isolated , have not been proactively supported to manage their long term conditions. We are fully supportive of new technology and this will have a high profile in the future, but for now we are engaging with our communities, supporting them with self care (this includes exposure to new technology) and mobilising the assets in and around our practice population to manage demand and provide high quality, patient centred care. What is the point of being kept alive until you are 120 if you have no quality of life and no human contact. Just a thought!!!

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  • I believe we will all be micro-chipped, and diagnosed by passing it over a scanner of some sort, or some connection to a centralised computer. All our health, financial and personal details will be chipped. Whatever, it's very doubtful I will live to see it, but it does worry me that human interaction will decrease. I suppose we come to accept these changes over time, as we have done to date.

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  • There is no replacement of human feelings and human touch ,Empathy ,Reassurence .Machines unfortunately cannot replace thease values and above all a doctor and patient relationship .General practice will always be there (Trualy it is Family physician).In the last 27 yrs I seen enough mutilation of this branch ,But human touch of a family physician will always be there .

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  • There is no replacement of human feelings and human touch ,Empathy ,Reassurence .Machines unfortunately cannot replace thease values and above all a doctor and patient relationship .General practice will always be there (Trualy it is Family physician).In the last 27 yrs I seen enough mutilation of this branch ,But human touch of a family physician will always be there .

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