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Don't denigrate profession in front of trainees, RCGP chair tells GPs

GPs should avoid making negative comments about the general practice profession in front of trainees, according to the chair of the RCGP.

Speaking at Pulse Live Birmingham, Professor Helen Stokes-Lampard suggested that although GPs do need to vent their frustrations, they should do so only when in the company of senior colleagues.

This follows earlier suggestions from RCGP for medical schools to crack down on negative 'banter' against general practice as a profession.

Professor Stokes-Lampard said: 'We all need a safe space to be negative and a safe space to vent. Use your peers and your seniors to vent. Don’t vent on your juniors, it’s destructive and unhelpful.'

She added: ‘For every negative thing you say to a trainee, somebody else has got to say ten or more good things to reassure them there is a future for general practice.’

At the same conference, Professor Stokes-Lampard also addressed the thorny question of GPs moving to a salaried model - after being forced to deny earlier this year that the GP partnership model was 'unfit for purpose'.

Professor Stokes-Lampard told the Pulse Live audience: ‘The partnership model won’t be right for every area of the country. Indeed in [one area of] Brighton all seven practices have handed back their contract. They just couldn’t recruit. The partnership model died there.’

Brighton has seen seven practices close in the past two years – including four closures that have displaced a total of almost 9,000 patients since NHS England’s support package was announced in April last year - and an eighth is due to close later this year.

Professor Stokes-Lampard also said that she was personally ‘sad’ that some areas had lost the partnership-model approach. But she pointed out that some areas do go salaried ‘because they’re visionary and some do it out of desperation’.

She added: ‘It’s sad but it’s the way it is. I’m not going to try and hide the truth. This is a fact.

'Some parts of central London, some parts of Birmingham, and well Brighton, [the partnership model] is gone.

'It was too late, it was too difficult, they had to do something different and be creative. And they have turned it into a success in some places.’

She warned that the hardest thing about changing from a partnership model to a salaried one is retaining sensitive patient care.

‘If you care about your patients, you want to have a long-term relationship with those who need it.

‘You get a better therapeutic relationship if you know the patient, their contacts, their family, their social and psychological factors as well as their physical – and retaining that is difficult but it’s being done brilliantly in some places.’

Should GPs talk up the profession to new entrants?

Professor Stokes-Lampard’s comments come as the GP recruitment crisis does not appear to be showing any signs of recovery.

In May, Pulse’s annual practice vacancies survey was answered by 860 GPs and revealed that 12.2% of all positions are currently vacant – up from the 11.7% reported at the same time last year.

The RCGP and Royal College of Psychiatrists teamed up last year to call for an end to negative 'banter' in medical schools, which they claimed amounted to 'systematic denigration’ of general practice and psychiatry careers, putting off graduates from choosing the specialties.

Although the campaign had the hashtag #banthebash, the colleges insisted at the time they were not about 'prohibition of banter' but about ‘fostering respect between specialties'.

Meanwhile, medical schools which aim to boost GP trainee uptake by exposing students to general practice could see extra funding, under Government plans outlined earlier this year.

Readers' comments (76)

  • I can see why some GPs want to be honest and advise those coming up to just not do it. But these are assuming things stay the same. And also, you have to be practical. If you push people away from GP, the strain left on the rest becomes higher.

    I think her point of keeping it to seniors is to make the complaining productive to people who can change things. I think complaining to students is counterproductive as it reduces uptake. Also primes them to create echo chambers - to hear the bad news not the good.

    Also by actively highlighting what is good about the job (of which there must be some keeping people in the profession) rather than the negatives, isn't lying. It's how balanced you wish to come across. If all of the commentators here really hate their job that's fine, but for every one of them there are 9 others quite happy and don't feel the need whinge.

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  • Many thanks for your reply Cedric,but you haven't pointed out anything positive..... its not miserable moaning...... its called 'calling a spade a spade'. I am now in Tasmania. I spent yesterday on the gorgeous northern Beaches. I had a glass of local Pinot Gris (AKA p.Grigio) and had a squid salad- locally caught, sitting in what is the winter sun here..... gorgeous, That is not miserable moaning, thats called problem solving - i.e. my reading of the situation in the UK= bleak, opportunities better abroad therefore solution = move. By doing so and I would encourage others to do so too, this helps make the case for improving conditions by adding to the 'brain drain' . Its only when we let it collapse will the government do anything. Jeremy Hunt relies on doctors like yourself to keep going beyond the point of rationality to validate his argument by proving you will keep working along with his demands. By emigrating I am adding to the argument that conditions need to improve, by continuing to work, you are not.
    Please advise me what is so worth waiting for? You didnt answer why you're not a partner? You don't say how it will get better? Are you trying to convince other people or yourself? I am not denigrating the profession, I am simply mindful of the conditions now experienced in the UK and have realised that for me, there is no future in the UK, I am not willing to go down on a sinking ship for the benefit of Jeremy Hunt. I disagree completely with you, I think losing the next generation is exactly what is needed. Can you imagine headlines 'Not one GP' - when we achieve full migration or exodus of an entire year of GP trainees, this would be great for the profession..... much better than crushing their optimism under crumbling system.....HSL is wrong. The evidence up to now is that the current approach has not achieved anything tangible. A new medicine is needed for the profession. You cannot negotiate with the current government, they just keep spinning the profession along, perhaps they're dangling carrots at the top for subservience..... but the grass roots I speak too, who are much less vocal than myself, do NOT see anything getting better. They don't believe the RCGP/HSL can actually deliver anything. Do you want to have a bet how much will have been delivered in the next 12 months? I ask you again, why are you locuming if its so good?????

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  • Dear GP trainee
    General practice is good.... let me highlight the best bits NEW ZEALAND, AUSTRALIA and CANADA. I don't hate my job, I just have a feeling of foreboding about the future of young trainees like yourself in the UK system. Whilst I have left the UK I do actually care about the NHS which is a great system, but private and corporate medicine and the self interest of politicians and some at the 'top' of our profession might not have YOUR best interests at the top of their agenda, but news flash here, profits might be more important than you. You need to be aware of those who would exploit you. Former RCGP heads are doing very well out of the salaried model....not exactly equitable for trainees like yourself, and not something that is discussed freely enough. You need to be aware of the good and bas bits and come to your own conclusions but you do need to hear ll the views. Hey Coal face GP where is your voice? All the GPs in Fermanagh think the current system is great don't they?

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  • Vinci Ho

    We always serve for the principle:
    'I disapprove of what you say, but I will defend to the death your right to say'
    Voltaire
    The thing is we never would denigrate our profession but we denigrate various politicians and governments which had shown our profession no respect and did not, for one minute, stop politicising general practice in this country. That's why I always say , you may not be interested in politics but bloody politics is extremely interested in you , mate.

    When we help people to make an well informed and consented decision , we present the advantages as well as disadvantages openly , transparently and honestly. That is at least what I was taught to do ........

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  • yes, I will never do such a thing again,Sorry

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  • hello macdonalds medicine(and I do feel sorry for you having to dodge all those spiders, snakes and opera out there) - I agree completely that ' a new medicine is needed for the profession' - but the way to this is to encourage the brightest and best graduates to enter GP, not to scarper to the other side of the world and risk getting skin cancer.
    Yes I am a locum- I visit lots of practices, the job is essentially the same in each, but the most striking thing is how some practices in one locality can be fun to work in with committed upbeat doctors and staff and how others can be so dreadful with demotivated staff and miserable doctors who presumably spend their time whingeing in posts like this in Pulse. We just mustn't poison students and trainees with the latter.

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  • GP,s should be honest with young doctors and not ventilate their anger/frustation inappropiately. Ventilate with Peers by all means.GP recruitment and retention will not improve while current conditions cotinue. RCGP must pressure NHS England and Government to value Primary Care better.

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  • Cedric , I have been a partner and a locum - the job is not comparable . Unless you have worked as a partner which is what General Practice needs I don't think you have a full understanding of the problem.
    I didn't find locum work stressful but partnership was a different matter.
    General practice won't survive on the backs of locums but I couldn't carry on in martyrdom as the workhorse of Primary care.

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  • Why locum gps are locum? Did we tell them? They choose locum over partnership. Why?
    That's what they decided to do facing and experiencing partnership.
    The one who left for Australia also made their own decision. Did we throw them out? No.
    The one who are still working as gp have their own reasons. We are stuck here for personal reasons. Rcgp blaming gps for their bad results.

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  • Just for info I was a nine session/wk partner for 30+years then decided to take it a bit easier and work as a locum - so there's almost nothing I haven't experienced or seen as a GP.
    My advice to younger colleagues i meet who are locums or salaried is always think about partnership, there are lots of risks, blocks, responsibilities etc etc, but get it right and its unbeatable- the main thing is finding a practice with forward thinking positive partners , not the patient/college/government/everything else hating colleages who seem to inhabit the pages of Pulse.

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