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Gold, incentives and meh

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)

  • Stress is part of the job description and the State pays us handsomely for that.It even provides us with a generous pension that we as self employed independent contractors shouldn't really be entitled to.Our families know perfectly well what we have signed up for.So why all this moaning and groaning and the specious mawkish sentimentality.I'm glad Pev has recovered and ready to return to work.

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  • Mr Nobody at 9:47pm
    GET A LIFE!

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  • When excessive workload, unsafe patient care, and falling income, causes partners to leave, and replacements can’t be found, there will inevitably be just one partner who has to pay for all the practice’s liabilities when the practice becomes unviable.
    To avoid this, practices could start building up a separate fund, to cover liabilities should the practice close. Otherwise the last remaining partner faces an unfair burden, perhaps having to sell their family home, or even bankruptcy.
    All practices should consider doing this as soon as possible, while there are still sufficient partners to spread the load. Of course this would be very expensive, probably wiping out drawings for many months, but it could avoid the nightmare situation that Pev is in.

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  • Wow Pev! Look at all these amazing comments. You should feel proud at what you have achieved. Now its time to be free of the shackles of General Practice and enjoy the rest of your life.

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  • Omg
    Phil I wish you a speedy recovery and hope you can find a way out of all this with your health and sanity preserved.

    I'm glad I got the hell out if England aged 32. They were going to make me work until 68. I was closer to 28 and realised I couldn't carry on as a 9 session partner. Some of my colleagues who were almost 60 were ready to jump ship too when I was leaving and have since retired. What a heartless and cold place the country of my birth has become. Even the ill health of a dedicated professional unfortunately these days wouldn't raise an eye Lid from the powers that be. This is a symptom of society over there I'm afraid. Doctors in England are seen as public "servants" and not parents, children, husbands wives or fellow human beings. Almost there to be used and thrown away. The fact that you earn a decent living makes it all the more acceptable to be reviled.

    The public will very shortly get what they deserve from health professionals when there's no one left willing to martyr themselves for this wretched thankless career in this hostile unjust system.

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  • This 9:47- is that a healthcare professional or somebody from Mars-
    '' Stress is part of the job description and the State pays us handsomely for that'' - Sorry, that was not specified in my job description - probably in yours as you are working for LMC/CQC or NHSE because you don't even have any details on your post just a veil of anonymity.
    ''Our families know perfectly well what we have signed up for''
    Sorry again, our families did not sign up for this mess which none of us could have foreseen. Do you belong to the clan of Nostradamus?

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  • There's always one............. 9.47pm please explain why, if the state "provides" us with a generous pension, 27.5% of what I earned last year was taken back as pension contribution? For some Drs their pension contributions amount to 28.5%. And in case you hadn't realised, the government have fiddled with not only contribution rates, but also unilaterally changed the terms and conditions of the current scheme so that we will all be worse off then before.
    Anyway, I am cross with myself for even bothering to reply to your nonsense, and I suggest you read your post again and have a think about whether this is really the most appropriate forum for whatever beef you have with GPs. This forum is to show support for a fellow health professional whose dedication to the job and his patients has made him ill. There but for the grace of God etc..............

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  • dear pev
    look after yourself mate. get out .retire to spain.
    dont miss this warning
    NHS HMG the punters and 947 anonymous wont be there for your family if you dont quit.

    we did not sign up to be dumped on by society and work to extinction

    when it all collapses be elsewhere

    and the really best wishes

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  • Pev, get better soon and then get out.
    Balint groups? Ah, isnt it cute that some people still believe it can cure all the ills in the world.
    An aside to Pulse..this really is the time to restrict this to health care porfessionals after some of the strnage bordering on sociopathic reponses listed above.

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  • Phil you are obviously an exceptional GP with such valuable insight that you should be advising the powers that be how to fix things. I wish you a speedy recovery and thank you for your wonderful columns which have inspired us all.

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