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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

Dr Paul Hobday - online

 

Name: Dr Paul Hobday
Age: 57
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.

Readers' comments (11)

  • as a GP who spent 30 years in contiguose practices in Lincolnshire this brings back memories. Glad to remember the clinically good days glad to be out of the present maelstrom

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  • i'm now 53 in practice for 25 years and i agree completely.
    i wish you well..the main problem of the nhs now i feel is the cult of 'managerialism'..(eg stafford)we must have a return to a clinically led nhs and have the self belief that comes from experience and knowing that the basics of interpersonal care are many orders of magnitude more relevant/important /cost effective than the constant stream of ridiculous and laughable schemery from the dept. of health/think tanks/private interests/parliamentary nexus..their ignorance is only exceeded by the damage they have done to the NHS..they have proved time and time again..'if it ain't broken don't fix it'..and that they are not fit for purpose and in need of reform...or at least to take their meddling sticky fingers away from the NHS.

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  • wishing you a very happy retirement Paul, glad you are still going to be around to "fight the cause " ! Anne

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  • The core of primary Care has always been the patient/go axis and on occasion the consultant with final clinical responsibility. The patient knows where the buck stops. Death by pathway creates a buck passing derelict system.

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  • It's realy uplifting to know there are still some decent honest people around, good luck in your new venture

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  • Wonderful uplifting and inspiring blog, you have my vote already! From someone who is nowhere near retirement it cheers me up to know that there are other people with similar views out there

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  • I thank Paul for his comments which so truly echo what I also feel-and I retired at the end of July with mingled sadness and huge relief.

    i am discovering there is life after general practice but you need to plan emotionally and financially !

    The overwhelming message in the hundreds of cards and letters I received as I left is that patients really do value personal care-the challenge for the next generation is how this can be delivered in the face of continually increasing demand.

    Most GPs need to see less patients and spend more time with them -many patients need self care/pharmacy care/nurse led care/patient group care.

    Politicians -wake up and help us to effect change !

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  • Paul,as someone who has worked in a nearby rural practice in the Weald of Kent for the last 30yrs I concur with most of your comments and thankyou for your local leadership and commitment to General Practice. I also realise that had I worn a beard through most of my career, then shaved it off near the end and had a decent photograph taken, I too might look younger and fresher than I did 20 years ago. Well done!

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  • Excellent, Paul, I applaud you. What seems to have been forgotten in the present cost containment climate, and which helpfully formed our predecessors' opinions. Some very nasty Nazi Doctors did unspeakable things to captives in concentration camps as a result of being employed. Doctors should remain Independent of Management whatever the inducements maybe.

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  • All the best Paul. Most insightful article for someone who is very much at the start of their career in general practice. Many thanks

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