Is a career in general practice only for the strong?
Medicine has always been a career based on strength, Dr Jenny Wenman writes, but facing down the commissioning challenge GPs need more than ever to admit they are vulnerable too
Strength of character is deemed essential as is both mental and physical toughness. Survival of the fittest really does seem to apply during medical school and the GP training years. Even once these are completed the world of medicine is increasingly more challenging, even for the strongest. With this ethos of strength comes a more insidious downside, which has always been somewhat of a taboo in medicine. Weakness is something to be hidden, denied and above all never shared. The penalty for showing your vulnerable side can be perceived as destructive to career and reputation.
Junior doctors are put under an increasing amount of pressure to learn more and more in isolation from their peers and senior colleagues. But more experienced GPs also find they have decreasing amounts of time and study opportunities in a world where protocols and therapies are changing with increasing frequency.
The public have more influence over a GP's career now than ever before and the media play a large part in their perception of the profession as a whole. Many GPs do not dare to let their guard down even in front of their colleagues and would never to show weakness or indecision for fear of reprisal or being perceived as weak or failing.
GPs learn through their junior years to emit an aura of confidence and strength at all times when working with patients and colleagues in order to show ultimate control over situations which can be frightening, emotional and stressful for both patients and doctor. The need of GPs to be on top of things, to know as much as possible is greater than ever and the pressure to be confident and correct at all times, is reaching overwhelming levels. The fear of litigation and complaints is ever-present and the practice of defensive medicine increasingly commonplace.
No patient wants to believe that their GP is fallible, or weak or indecisive, but all these weaknesses are human qualities which everyone has - GPs included.
However, these are not seen as human qualities but as failings by the media and by medical professionals themselves. Not always having the right answer, not being eternally confident, asking questions of colleagues and asking for help can be seen as weak, a sign of failing or under-achieving.
This leads to many GPs being increasingly reticent to ask for advice and help from their fellow colleagues. Dealing with the neverending levels of uncertainty is an art form and although a small percentage of GPs acquire this skill, many can find it difficult to manage to a greater or lesser extent.
Because the profession does not encourage the sharing or acknowledgment of difficulties, many GPs find themselves isolated from each other when in reality the problems faced are shared by the majority of the profession at one time or another. This in turn may indeed lead to GPs using drugs and alcohol to cope with the need to maintain an outward aura of confidence in their isolation from their colleagues.
The need to ask questions and get help would go a long way towards making GPs more confident and more successful, rather than less.
If GPs felt able to voice concerns or worries, to discuss uncertainty and options with fellow colleagues without fear of reprisal, ridicule or even loss of future employment, it could lead to a more positive and successful learning and working environment for GPs of all seniority.
By removing the taboo of perceived weakness and allowing uncertainty and asking for help to be seen as acceptable, GPs will be free to be honest with themselves and their colleagues and hopefully become less stressed, more supported, supportive and successful.
Dr Jenny Wenman is a part-time freelance GP