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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)

  • Best wishes Pev. Please look after yourself
    To all the trolls with insensitive comments F*** off

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  • Good luck for the future. I have always enjoyed your articles - please, please stop while you can still enjoy some decent retirement.

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  • Best wishes, know how you feel....I'm aged just 43, just been referred to Rapid Access Chest Pain Clinic. Finished work at 9pm Thursday then rather collapsed.

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  • How will a Balint group or mindfulness resolve the overwhelming level of work at Phil's practice? There needs to be a more practical solution before the sick note can finish. Get well soon Phil

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  • Phil thanks a lot for all your wise and amusing words over the years. Please take it easy there is very much more to life than general practice. Too many of us soldier on becoming martyrs.

    Phil is not alone. Many GPs are in very similar situations.

    Why aren't the GPC and RCGP taking action on our behalf? They have a duty to all GPs to support us. They are Doctors and because of this have a Professional duty of care for us. This is above regulation and contract negotiation. Why are they not conducting their own research into how many GPs are facing similar positions? If we ignored our patients in the same way they ignore us we would be reported to the GMC.

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  • Phil - I retired aged 60 a year ago after 30 years as a GP and 8 in hospital. I loved it and it was my life but it became all consuming to the detriment of any other activity at all. I was slightly worried I might miss it and get depressed, but I have had the best 14 months of my life since I was a student. From the first day I have never looked back and don't miss it a jot. In fact I have a huge sense of relief and freedom tinged with huge sympathy for everyone struggling on. It isn't possible to practice high quality caring family medicine any more. Look after yourself and get home to your family. Enjoy yourself - there is life after General Practice!

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  • Get well soon phil
    please give Vinci Ho a column

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  • Pev, you've been an inspiration to me and your insights on Pulse and DNUK have been helpful in waring the Australians of the fate the awaits them if they follow the UK implosion of primary care

    You've done your dash fella - time to back off and enjoy life

    ..and please, if you ever get Down Under, pop into Kangaroo Island and see how we practice.

    Resilience - sometimes means saying 'enough'

    Take care big fella

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  • & Anonymous | 31 May 2015 11:02am who wrote "it isn't possible to practice high quality caring family medicine anymore"

    If you feel like that then you're burnt out.This is where Balint groups and resilience training can be very helpful.It should be made a compulsory component of VTS training.

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  • Phil, you have a DUTY to your family to get out. I wish you all the best.

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