Cookie policy notice

By continuing to use this site you agree to our cookies policy below:
Since 26 May 2011, the law now states that cookies on websites can ony be used with your specific consent. Cookies allow us to ensure that you enjoy the best browsing experience.

This site is intended for health professionals only

At the heart of general practice since 1960

GP land: over the hills and far away

  • Print
  • Comments (10)
  • Rate
  • Save

I was a medical student and I was in a clinic with one of my favourite doctors. He had a two-eared stethoscope (the only one I have ever seen to this day), would often hand me the drug chart during bed side teaching and ask me for a differential diagnosis and he called me Faiza for a year because I once sat in Faiza's chair. He was so nice I didn't mind that after six months he's still called me Faiza.

One day in clinic we were trying to contact a GP surgery to get more information for the patient who was in front of us, a confused breathless man. We called several times but the line was engaged and then no one would pick up. No luck that afternoon.

Something as simple as the language we use can shift attitudes a little

'No response from GP land'.

This was the first time I had heard the term and since then it's not been an uncommon term for me to hear around the hospital.

When I first heard it, it reminded me of something akin to the telletubbies: 'Over the hills and far away the GPs come out to play?'

Language and choice of words interest me. GP land is banded about all the time. In general conversation, in on call rooms, in multi-disciplinary team discussions, but do the words we have have an impact on how we view certain specialities? 

GP land is far away from us 'the hospital'. GP land is unrelated and like the telletubies say, over the hills and far far away. Once the patient is there they are very much someone else's responsibility, the GP's, there to pick up the pieces after a hospital admission at the mercy of a discharge letter for information.

The patient, who every physician will agree is at the centre of their efforts, has interactions with so many different specialities but the 'us' and 'them' attitude between doctors in every speciality still surprises me. It doesn't help. Being a junior doctor you quickly move around specialities and you straddle the line between us and them. One day you're 'with the surgeons' and the next you can be in 'GP land'. Same patient, same you, but a different hat and different outcome even though ultimately we all want the same thing; the best outcome for the patient.

One of the hardest hats to wear is that of a GP's in GP land. The hats there don't have the fancy gadgets of the hospital.

In an ideal world patients would move seamlessly between primary and secondary care but as long as 'GP land' and the 'big bad hospital' attitude exists we as clinicians don't help things. Yes there are bigger reasons behind the sometimes not so seamless primary to secondary care exchange, but sometimes something as simple as the language we use can shift attitudes a little and change thinking from 'us' and 'them' to 'we'.

Dr Salma Aslam is an FY2 doctor in the North-East

Rate this blog  (4.83 average user rating)

Click to rate

  • 1 star out of 5
  • 2 stars out of 5
  • 3 stars out of 5
  • 4 stars out of 5
  • 5 stars out of 5

0 out of 5 stars

Readers' comments (10)

  • It doesn't help that some hospital Drs don't realise 'patient land' has a postal service and telephones, preferring to contact us to write a blood form for the bloods needed for the next hospital appointment rather than sending the patient a form directly.

    Unsuitable or offensive? Report this comment

  • Mr Mephisto

    I frequently have patients come in to see me to get an explanation of whats been happening to them in "Hospital Land". Hospitals are very bad at communicating with patients even if the hospital doctor can actually speak English. My patients are not overly enamoured with "Hospital Land" services and frequently seek a second opinion as they are not entirely confident about "Hospital Lands" management. I have even had patients phone me from their hospital beds asking for management advice as my "Hospital Land" colleagues were obviously failing to come up with a diagnosis or management plan. I had a patient come in to see me this week with a bag full of blood bottles and forms - the hospital had failed to get blood samples on two separate occasions and sent the patient to "GP land" to get his blood samples taken. Happily I was able to perform my "GP Land" duties and succeed where "Hospital Land" has failed.

    Unsuitable or offensive? Report this comment

  • It's all about tribes, and for some AAA people, battling to become the leader of their tribe (look at RCGP, GP Federations, LMC leaders). Then battling to get power over other tribes, and is the cause of wars. Politics is there to try and prevent wars. When Politics fails the result is war. Sadly refusing to join a tribe can be very dangerous, which is why most people are sheep...safety in numbers. No difference with other animals...very upsetting.. Darwin was right.

    Unsuitable or offensive? Report this comment

  • Of course there are a lot of patients that live in 'Teletubby Land', and being mere 'children', look for guidance from 'Hospital Land' (father) and 'GP Land' (mother). It can be confusing for them when their two parents argue and can eventually lead to behavioural problems.

    Unsuitable or offensive? Report this comment

  • Mr Mephisto

    Love the above comments 10:43am + 11:07am - brilliant insights - seeing the problem form very different angles - fantastic

    Unsuitable or offensive? Report this comment

  • Vinci Ho

    Where there are people , there is politics.
    Politics so easily fails time to time .
    War is last resort and inevitable on this earth.
    Where there is war , there is collateral damages.....

    Unsuitable or offensive? Report this comment

  • @1107 is probably the best summary of this problem I've ever read. Fantastic stuff.

    Unsuitable or offensive? Report this comment

  • A drug addict moved to our surgery .his old GP refused to talk when called even though we were neighbours. I heard there was a fight in 2 surgeries between partners nearby. Police were called hair pulled , shotgun removed.
    So I called his 3 rd GP .. He said the gmc we're dealing with the case of alleged assault by GP on patient...no comment

    Unsuitable or offensive? Report this comment

  • ..... and while GP Land and Hospital Land battled out as to who was responsible for what the patient went to Angel Land never to be seen again

    Soon those in Hospital and GP land found themselves in CQC and GMC Land.... the place they didn't want to go

    ... and so to escape the distress of the whole situation the doctors looked to another land........ this was the land known as....
    Australia

    Unsuitable or offensive? Report this comment

  • Mean while the patient lives their lives at home and really couldn't give two hoots

    Unsuitable or offensive? Report this comment

Have your say

  • Print
  • Comments (10)
  • Rate
  • Save