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At the heart of general practice since 1960

This time could be different

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Pulse in the past week or so has made dispiriting reading. Roughly half of 2,700 GPs polled are considering quitting the profession, and a similar proportion feel that their workload has now risen to a dangerous level.

These two phenomena are clearly linked. And this is why the current impending crisis may prove to be very different from the crises of the past. GPs today are dealing with more complex patients than ever before, as pressures on secondary care push more and more into our domain. We are also seeing an unrelenting climb in the sheer volume of work. We are not sat in our offices drinking coffee, lighting cigars with a burning fifty, and waiting for the hospital to send us a patient or two.

Nerd that I am, I can recall exactly what convinced me to become a doctor. Around the time of my A-levels, I was bought a book with an oddly aggressive title, something like: So. You want to be a doctor.

The line that got me seems embarrassingly saccharine now, but here goes. It was: “At the end of your career, you won’t be counting the number of rich people you made richer, you’ll be counting the number of people you helped”. Ludicrously, it really was that simple. A job that’s interesting and useful? In which you’ll never get a City-style bonus, but you can be proud of what you did when it’s time for your gold watch? Yes please.

I’m pretty sure the motivations were similar for the majority of us - the ones who are fairly apolitical, enjoy patient contact most of the time, and don’t like doing administrative tasks unless we can see how it will help the person in front of us. I suspect we’ve given ground on so many things in the past because, for most of us, money wasn’t ever the main driver.

We’ve demonstrated that we’ll tolerate our pensions being mucked about with, and that we’ll sullenly get back to work after agreed contracts have been ripped up.

But the underlying message of those two statistics is that we do, perhaps, have a limit. And that limit will come when we are forced to practise unsafely. For all its faults, I still love the job, and believe in its worth. I don’t want to see it destroyed.

But it will only take a fraction of that 50% of GPs to carry out their threat, and the profession will be over. We can only hope those in power realise, before it is too late, that GPs just might mean it this time.

Dr Nick Ramscar is a GP in Bracknell, Berkshire

Readers' comments (6)

  • David Bush

    Nicely put, Dr Ramscar. I agree with you that one of the problems is that most GP's have a personality that is very different to those in politics. We have no interest in playing their games (which involve compromising one's own integrity) and so they win those games every time.
    Will the worm turn? I don't think so, but he may well slither off to pastures new.

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  • Save yourselves, get out while you still can.

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  • I believed that every change brings a challenge and I revell in challenges. However, this current set of changes are quite impossible. Like lots of colleagues around me, I have decided to throw in the towel and am submitting my notice to retire. Sad, but one had to protect one's sanity.

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  • If you think about it, the older GP in 1:2 rotas worked 168 hour weeks when the other half went on holiday, did 80 hour weekends with or without sleep routinely. No private company could have got away with such torture. It was like burning people at the stake - just wrong. But we did it.
    We should have said no then and we should say no now. Work loads are dangerous - extremely. Again, we will bleat like sheep, but do nothing. Forgive me, I was a coward too and did those hours in sleepless fog and thought it akin to slavery, but never said a word.
    GPs around the country are suffering depression and anxiety in spite of working like donkeys, but at the end, nobody will do anything, because they are like me, plain stupid.

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  • I'm one of those people who is dying to kick up a fuss and do something- but I seem to be the only one. My colleagues are happy to moan but no one will take any action. And if I try to do something myself- who can I go to?

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  • I agree. Market forces are clearly the only thing that will prevent the continuing assault of declining income and increasing work and assorted hassle, our ability to resistt having been shown to be a pathetic busted flush. Will private providers find it easier to recruit docs, or will they go with a cheap skill mix?

    The more younger colleagues emigrate, and older ones retire, the sooner we shall have a bargaining counter. At present we are in full scale retreat without even a rearguard action, and HMG are piling in with their boots

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