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I'm with Ian. There are reasons to be cheerful

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For the first time since I have been writing for Pulse, I had a little editorial nudge for this month’s column. ‘It’s the good news issue and we want to pack it with optimism for a change,’ said Nigel.

Now if this had been asked of me six months ago, I would probably have written a column to rival Sylvia Plath’s The Bell Jar.

There are still reasons to be cheerful as a GP

But my life has become immeasurably better since I resigned my partnership in mid-May. I feel as if I can breathe (and see more clearly) again. The mental imprisonment was far greater than the sheer magnitude of the workload, although I am celebrating being free from both.

Yes I am still a GP. I continue to work in a salaried position and can easily contain my clinical workload through a combination of experience and the ability to say no.

So – what have I got to be cheerful about? Well, I’ve started running again three to four times a week. I go out with the mums on a school night. And I can get home in time to play with my kids before eating dinner with them. (‘Mummy, you can play football with me now because you’re not a partner,’ my six-year-old said).

But best of all, I’ve started enjoying my job again. Now I am free from the anxieties of running a business on a shoestring, I can relish the tapestry of the human condition. I can proactively follow patients up instead of reacting and firefighting. I can take pride in managing a psychotic patient who is confiding in me, rather than the crisis team, instead of washing my hands of her as soon as the referral is sent. I can see the difference between patient gratitude and patient dependency and how the former is vital.

Of course, there are still the same irritations – the unreasonable expectations, the social issues, the dumping ground. But all of these feel less personal and more manageable when you are in a better place. And the most extraordinary thing about it is that I am in a better position to look at the business model objectively. In other words, I am likely to make better partnership decisions when I am no longer in the role of partner.

Unlike some GPs with a public profile, I am not advocating an all-salaried GP model, even though I think we are heading in this direction. I have enormous respect for my partner colleagues who are staying the course, as it is they who are being exploited by this Government. But my advice to them is the same as my advice to a friend who was recently appointed deputy head of her school: ‘Keep checking to make sure you are okay – because no one else will.’

I will leave you with a quote from a dear friend who also handed back his partnership deed: ‘The good news is there are loads of opportunities for experienced GPs post partnership.’ And he is right.

Ian Dury may be disappointed that the Hammersmith Palais is closed, but there are still reasons to be cheerful as a GP. You just have to clear your mind to see and appreciate them.

Dr Shaba Nabi is a GP trainer in Bristol

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Readers' comments (16)

  • The question, both corporately, and individually is 'what does this look like after the NHS?'

    Answer that, and you have half a shot at it.

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  • Dear Dr. Shaba Nabi,
    I am truly delighted that you have got your life & your peace of mind back, that's what we all are entitled to !
    However, not being a GP, & despite reading the explanations,I am still finding it extremely difficult to understand WHY so many of the disgruntled, depressed (& depressing) contributors to these blogs actually remain as GP partners !
    Can someone explain it to me SIMPLY, please !!

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  • I have just left a salaried job after 12 years and feel a similar way to Shaba. In fact I keep bursting into manic laughter especially when I find myself driving to a job in the opposite direction to my old one. It is so un-tethering, in a good way, to become your own boss, in control of your own workload. I have found out that I can work really hard and long hours (it's Saturday, I am working - well, sort of - there are no patients!!) if I choose to. I just hate being controlled by someone else. I don't really know how partners can stand it. They aren't autonomous. In any way at all. The good news for doctors (at the risk of sounding like an oddly cheery on-looker at a car crash) is that the demise of the NHS is causing an exponential rise in ways we can earn a crust. Suck on that Hunt!

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  • To 1157
    I don't know. The job is awful now. There is no time to breathe in a day. Constantly worried about missing things under such pressure.
    But kids at school, mortgages, share of the surgery and earning a living. It is such a trauma to move everything, se we stay.
    DOES NOT mean that the job is not horrible.

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  • to 1157
    * General Practice is self-employed, small business and we like it this way.
    * We want to keep our independence and not be dictated to by Virgin Health, Capita and hospital chiefs.
    * We remain optimistic that once the storm is over, general practice will flourish again.

    The salaried and locums (Hansel and Gretel) will soon realise that they have been trapped into the sugar house by the cannibalistic witch,but, unlike the original, theirs is not go to be a happy ending.
    You have been warned Dr Nabi!

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  • @11.57
    Don't let the Pulse comments fool you.They're always skewed to the negative.The fact is that out in the real world GPs are still quite a contented bunch.Money isn't bad and there is a good steady supply of young eager doctors to do the donkey work.

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  • As a partner you could have employed a salaried slave with halve your income.. And become a silent partner.. Confining yourself to purely the admin side of things..
    That's what a lot of husband wife partners do when one spouse can't work anymore for whatever reason..
    Quite insulting for the Salaried to do the same work for less... But lots of young fools will
    None will abuse you more than ourselves

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  • Can you imagine presenting General practice on The Dragons Den.. In the words of Duncan Banatyne... Am oooooot..
    Gen practice is a really noble and honourable profession
    and it is a joy to look after people and make a positive difference.. The proble is that we are expected to martyr ourselves and families

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  • GP partnership is a full time job with the stress and rewards that are associated with that responsibility. It is clear that many GPs no longer want that stress but they also cannot expect that reward and they should be willing to accept salaries more akin to those of our very hard working and capable nurse practitioners.
    Shaba- I respect your views and work ethic, but I am not surprised to hear that you found it impossible to shoe-horn GP partnership into your busy portfolio career- so please don't completely write off GP partnership, and please don't imply that I am being exploited by the Government and cannot say no just because of my self employed status- GP principals- abandon that independence at your own risk- but if you see GP as less of a vocation, and more of portfolio/part-time Job, then GP partnership is not for you.

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  • So, once the stress levels have reduced to your more manageable levels you began to feel a bit better. What's the news? What is this compulsion to share your experience?
    I'd rather hear from someone able to cope.

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