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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)

  • Just to add my agreement with all of the supportive comments above who have put things better than I would be able to. I realy hope that you will be able to look back on this as the point when things started to turn around for you.

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  • Thanks for your great writings Dr Peverley. The time has come to put your family and yourself first. I wish you a speedy recovery and all the best for the future.

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  • I left several years ago due to burn out and rented back my surgery to the then PCT (now NHSE) who are obliged to provide medical services in the area. In the last few years they arranged for a private provider to take over. This company pays me the rent and employes salaried doctors to provide the care. I reap the rewards of the rent and don't do any work. It's a heck of a lot better.

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  • drat drat drat! Posted a one star rating in error. A gazillion apologies Pev, I meant to give you as many stars as possible. Your writings over the years have amused me, enlightened me, comforted me and made me realise that everyone else was hoovering up the same stuff day after day, week after week and year after year.
    I wish you a speedy and long term full recovery. GP would be a much poorer place without you, but put yourself first for once.
    Steve

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  • Phil,

    I am so sorry that it has come to this. Your articles over the years have been amazing but you need to keep extending that sick note and look after yourself now. It is not right that you should suffer any more - you would not expect your patients to go through this. Thanks for all your articles and good luck for the future.

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  • Get well soon Dr Peverley and good luck!

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  • Get well soon Pev.
    Do what is right for you.

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  • Bob Hodges

    I ended up in AF briefly during an OOH shift last summer myself. I was 14 hours into a 15 hour day in a 6 day week. I'm not yet 40.

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  • Can't believe some chumps think the answer is CBT, or a "Balint group". They'll be suggesting you need more "resilience" soon. Best wishes, Pev.

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  • I have enjoyed your columns for last few years and agree with almost everyone else. You have served your time well, now is your time to rest, enjoy your life you are a legend, get well soon

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