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Independents' Day

I've learnt to put my needs ahead of patients'

Dr Samir Dawlatly

Having had a summer holiday not too long ago, which I understand is fairly uninteresting to most people, I don’t have a beef with 'the system' at the moment.

This may be because I’ve gone beyond caring about the mess that is general practice in England, or more likely that I’ve realised that ranting about this has minimal effect, beyond creating a minor stir on social media for a moment or two. I have no illusions about my circle of influence.

I have, however, concluded that I may have actually reached a level of contentment and work-life balance. I now work six sessions and do some ad-hoc work for the CCG, supporting practices that have asked for help.

I’m no longer an LMC member, on the board of a super-partnership, or running a referral management scheme locally.

I’m cramming my six clinical sessions and associated administrative work and partner-load into three days, and using my days off to exercise, write blogs and pick up my share of the childcare requirements at home. I’m aware of how lucky I am to have achieved this balance.

By putting my needs above my patients’, I feel I’m improving my ability to care for them

Last week, I met up with a good friend with the same sporting interests.

We spent the day in Wales and I realised that achieving this kind of work-life balance was only possible if you ignore the first GMC 'law' of making the care of your patient your first concern. If my patients’ needs were really my first concern, perhaps I would have popped into work on my day off, or logged in from home to check that everything was OK.

I believe the GMC edict sets up a hierarchy of needs which places the needs of my patients above mine.

Perhaps, then, it’s no surprise that 90% of GPs (and other doctors) are at high risk of burnout, when for so long, the unspoken sentiment has been that meeting the needs of patients automatically has to come first. It forms the basis of the goodwill that the NHS is built on - doing unpaid work beyond contracted hours, for the good of the patients.

Of course, this doesn’t apply to GP partners who only have nominal clinical sessions rather than set hours. 

Ironically, by putting my needs above my patients’, I feel I’m improving my ability to care for them. The relationship between my needs and those of my patients is not hierarchical, but circular and interrelated. Maybe millennials, who are accused of looking after themselves foremost, have got things right. 

Dr Samir Dawlatly is a GP in Birmingham

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Readers' comments (11)

  • Cobblers

    This lesson should be compulsory reading for newbie or wanna be GPs. Look after number 1. Number one being you and your family.

    It is but a job NOT a vocation. Don't sweat it if the system conspires to feck up patient care, as it seems to all too often.

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  • RCGP take note. They won't, but they should.

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  • Amen Samir. I am yet to meet a colleague who on reducing their sessions does not reflect they should have done it years ago. Time is precious. And work will take and take and take until you have nothing left to give.

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  • My greatest fear was realised yesterday when my child returned from school having been told by their teachers that they should apply to medical school.

    In order to do this they were advised that they must start volunteering at the local hospital, work in a nursing home, and arrange to shadow a GP at work. This is apparently a requirement for application to med schools now.

    What kind of message is this? We have selected you to work yourself to death as we’ve identified that you’re smart and have an altruistic flaw. We’re going to make you start now, working for free, while you’re already striving to get top exam grades. Get used to it now as the system is going to shaft you, and keep on shafting you.

    During a career in general practice I’ve collected more painful memories and dealt with more traumas than most soldiers would experience on the battlefield. I rarely go on a (long haul) flight without having to give medical care. When I’m out shopping or out for dinner, patients continually pester me for appointments and prescriptions

    I’m not kidding. I don’t have any colleagues who would be happy about their kids going into medicine at the moment. And yet our colleges are starting the abuse of a ‘vocation’ before the kids have even started.

    More people at the top need to start telling the truth about what is going wrong with the NHS . Well done Samir

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  • Excellent article more you give the more the bastards take/expect.

    Drop dead at work and work still gets done.

    Personally worked with # arm, consulted during personal renal colic, stitched episiotomy with # wrist etc and no one from NHS E gives a flying f**k

    Done with NHS and April isn’t soon enough!

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  • Not worked for a practice for over s year . I have PPSD (Post Practice Stress Disorder )

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  • Psychiatrists have known this for years in working with patients. If you don’t look after yourself and become ill/ burnt out you can’t look after anyone else well.
    My husband, an anaesthetist has taken his first time off sick ever as last time he went to work feeling ill, he got a complaint from a patient for being grumpy. He won’t make that mistake again.

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  • I've noticed the exact same- as a locum I get asked "will you work here permanently" as I have lower stress levels and therefore consult better.

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  • It's like my time as an SHO on a surgical ward. You always had to make time to eat and get a drink - if you are broken then you can't look after patients and you will make mistakes.

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  • doctordog.

    Sam I still think you’re spending too much time at work.
    When we are on our deathbeds and looking back, let us not regret not being out enjoying ourselves on that sunny afternoon, rather than being in surgery or at some meeting

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