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Independents' Day

I can’t be the fall guy any more

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I have in front of me a letter from the A&E department. This is what it says:

‘This 15-year-old lad was playing football on Saturday, and lost his ball up a tree. He climbed the tree to recover it, but fell out from about eight feet and landed on his back. He did this four times. On the final occasion he fractured his clavicle.’

These letters give me the material for these articles. Human stories. The utter absurdity of the behaviour of homo sapiens. The basic material for 500-odd magazine columns, since I first started writing them 20 years ago.

The fascinating thing is the ambiguity. The obvious conclusion is that we are dealing with an utter moron, the type of dude Darwin predicted would be weeded out of the gene pool. But there is another interpretation worthy of serious contemplation.

Perhaps we are witnessing one aspect of the indomitable human spirit. The triumph of hope over experience. He kept climbing and he kept falling. It’s almost heroic. By definition, we only see the failures. Who knows how many teenagers keep climbing and get their ball back at the fifth or sixth attempt? There are probably many.

As I read the letter, I’m laughing and crying in equal measure. Because I now know this experience is nearly over for me. Because I can’t go on.

This article may be unique in the annals of Pulse because a decent proportion of it was written in a hospital bed, with 15 electrodes attached to my body and an IV drip limiting the use of my right arm.

The oxygen mask was hampering my vision and the pulse oximeter had to be transferred to a pinky, because I don’t type with those. But hey, a deadline is a deadline.

The fact that I was back in rapid AF and heart failure within an hour of getting back to work after a short holiday is not, I think, coincidental. The escalating workload, the tumbling income, the futility of trying to keep up with demand, the frustration of being the last port of call for so many problems that really are nothing to do with us; the sheer lack of time to practise medicine as it should be practised. It is insupportable that we are dumped on, taken for granted and held responsible for the failings of others. Above all, the total absence of interest in the vacancies at my practice makes the future as a GP partner unbearable to me.

My love affair with my profession is over. I hate this bloody job. I can’t stand going into work any more. It makes me depressed, unhappy and, latterly, literally sick.

I believe there is some currency in the Government’s ‘5,000 GPs’ idea, but I think they’ve got it the wrong way round. I predict 5,000 fewer GPs over the next five years, as people like me reach the end of their tether. I know of literally no one around my own age who is not thoroughly disillusioned. None of us will still be practising at retirement age. And there is no way we can be replaced, let alone the overall numbers of GPs be increased.

I have climbed my tree and fallen out too many times now. If I was stupid, I would get back up and start climbing again. But I realise that next time, I’m going to fall out and break something. In fact, I may already have done so.

Dr Phil Peverley is a GP in Sunderland.

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Readers' comments (156)

  • 10.14. Already doing it - 2 of our 5 partners are leaving in the next 10 months, and I have no intention of selling my house to buy them out.

    I can't see myself doing this job in a years time. 14 hours straight seeing patients today, and at twenty to eight I'm just starting to look at letters, results and prescriptions. I am giving it one year, and if nothing changes i'm off. Better to go before I break, or get forced to go when I overlook something hidden in the huge backlog of paperwork.

    9.47 are you for real?

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  • Dear Phil. I hope you make time to fully recover before making any decision to return to work. I am so sorry that it came to this. I am a dedicated and hardworking patient centred GP and went off with burnout at end Sept 2014- I could not go on but not so dramatically as you. I stayed in bed under the duvet for a week. Tried to make my GP and OCC health doctor let me go back after 5 weeks then after 6 months off with great support from our gold standard occupational health service for GPs in the South West (which has now been disbanded) I have resigned my partnership but am working as a locum. It was so enlightening being made to stay off for enough time to realise the impossibility of my returning and staying healthy. Give yourself time. I have no idea how the NHS will survive this Government but we mustn't kill ourselves trying to plug all the gaps.

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  • already given up hope NI GP

    Patient: Can i make an appointment to see Dr Phil
    Receptionist: Dr Phil has retired
    Patient; Oh dear,I really liked Dr Phil,can i make an appointment for Dr X
    Get well soon Dr Phil (only your family really gives a sh*t)

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  • I have to agree with all the above comments. I have enjoyed your writing for years and it always makes me smile in recognition of what we should all be saying out loud, but only think and cogitate on!
    Get well soon and have a great retirement, writing from your vast collection of memories, no doubt.

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  • Get well soon Dr Phil. Always appreciated your articles. Time to put yourself and your family first!

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  • Get well soon Phil mate. love your commitment and sincerity. Remember today is the first day of the rest of your life, so your happiness comes first, everything else comes next.
    Time for perspective and prioritizing those small simple things in life.

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  • I completely agree with your decision, Dr Phil. You can be assured that you have done your considerable best. . Looking forward to reading your retirement blog which I'm sure will be helpful for those many GPs put in your position by circumstances beyond the profession's control.

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  • Phil, I hope things improve for you.

    There are a number of online sites that we could use to send out a mass resignation letter. Just Google online petition or online resignation letter.

    Hamish Meldrum did this in 2001, but I don't think our current BMA representatives will do it, for whatever reason.

    The online letter would be automatically sent out to all GPs' NHS email addresses. It can also be optimised for social network sites such as Facebook and Twitter. Pulse Magazine could also help.

    The letter of resignation would go along the lines of stating what GPs would do e.g. Number of consultations per year per patient for the £126. Consultations over and above this limit would be charged directly to patients. The letter also should outline the proposal to develop our own private health insurance package that could be set up using any number of insurance companies.

    I'm afraid I'm too tired and worn out to do this myself, besides I shall shortly be retiring anyway

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  • Get well soon - and go out with your head held high if you do decide enough is enough. Speaking to friends and colleagues locally I'm not sure how many GP's are going to left in the NHS at this rate - Aus, NZ and Canada must be running out of space to fit former NHS staff some time soon....maybe you'd like to see out your career twilight years prescribing factor 50 lotion to those ginger sprogs that you mentioned Down Under there's an irony...and much more therapeutic than I think you'd find the Balint Groups...and thanks for the columns wherever they come from in future..

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  • LOL +++. . Hey , I still haven't forgotten the one re your cardiology stethoscope . After reading your article, I bought one especially to use on some of my more challenging patients ,it works a treat!

    Get well soon , send us a post card....

    53 yr old GP (soon to be ex). Yorkshire

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