Dr Paul Hobday: What I've learned from working in the same practice for 30 years
Dr Hobday has just retired from general practice and is about to start work as a pro-NHS campaigner. He explains the five key lessons learned from sticking with one practice
Name: Dr Paul Hobday
Role: Campaigner and retired GP partner
Location: Maidstone, Kent
Hopefully the timing of my retirement is right. I would like to claim to be like former Manchester United striker Eric Cantona - quitting at the top of my game before getting sent off for good (although I do remember missing a few open goals). Others though may think a better comparison is Paul Gascoigne.
Things that have gone well include spending my whole professional GP life in one practice - one that has survived all the changes in the NHS since the early 1980s. I worked at Sutton Valence Surgery, Maidstone, Kent from Sept 1983 to the present.
I realised quite early that I learnt little at medical school. Most useful knowledge came with experience. Having a medical qualification shouldn’t define who you are. It’s best to accept early on you are just another human being who happens to earn his living working as a doctor.
After my retirement I plan to focus on campaigning for the NHS - for instance, giving speeches at national NHS conferences. I am considering standing for the NHA against my local Tory MP.
Five lessons I’ve learned
Work out who deserves your patience and who doesn’t.
Patients nearly always do. Getting angry with them never pays off and often back-fires. Ride any irritation and move on.
By the same token, the irascible side of me doesn’t have time for those who tell us how to do our job when they clearly haven’t got a clue what it involves.
I wish I’d fought this harder, and not tolerated our ‘leadership’ as much as I did. For 25 years I sat in LMC conferences, trusting that GP leaders must know what they are doing and seen a theme repeated that ‘we’d better go along with what Government is proposing or it might use someone else instead’.
The result is that power has passed to the managers with doctors increasingly acting as mere sessional functionaries, sticking to ever more prescribed regulated and quantified duties, and being the ‘fall-guy’ when things go wrong.
I wish I’d woken up earlier to the plot
We are co-operating with becoming rationers of our patients’ healthcare, spending hours scrutinising financial spread sheets and seeing our reputation at risk as patients begin to question our motives (especially when they learn of the links some doctors have to profit-making healthcare providers).
I wish I’d woken up earlier to the plot - hatched over 20 years ago - against the NHS.It’s almost too late now. I feel like a World War II resistance fighter against forces that have invaded our great island NHS. I trusted the pharmaceutical industry too much as well, and look back on some of my prescribing with horror.
Small is beautiful
I’ve been in partnerships of two, three, five, six, seven and eight GPs, finishing back at two after a spell as a single-hander. Small is beautiful, and allows the best possible personal care. If in doubt, ask the patients, not the ignorant bunch of self-serving politicians currently destroying our NHS.
Develop other interests
Or be doomed to be swallowed up by medicine forever as you won’t know what to do when you drop off the ‘performers’ list’.
I’d encourage interests outside the practice even if they are full of the frustrations of the medico-political world. I’ve seen colleagues become insular and isolated, and occasionally ‘rusty’ as a result of just doing the ‘day-job’.
Another antidote to general practice for me was developing one of the first co-ops in 1990, but I’m not so pleased with the direction out-of-hours care is taking now. The blame for this lies totally with the politicians not our profession.
Plan well ahead
I would urge all those GPs starting out to plan well ahead, especially financially. Then you won’t outstay your welcome, which does you, your patients and the profession no favours.