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This is it. From now on, I choose life

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I am neither religious nor spiritual. Yet it is the Serenity Prayer I refer to most in times of need: ‘God, grant me the serenity to accept the things I cannot change, courage to change the things I can change, and wisdom to know the difference.’

Although I have saved my sanity, I feel huge guilt

As an educator who has indulged in extensive navel gazing, I am aware of my strengths. I know that courage, but not serenity, is one of them. So I’ve spent the past nine years as a partner trying to be courageous and change things. I’ve tried to manage patients by ensuring consistent practice policies. I’ve tried to manage demand by discouraging dependency and fostering a culture of self-care. I’ve tried to manage recruitment by diversifying the workforce and creating a supportive training environment.

But this is a battle where I am faced with weapons of mass destruction and all I have is my bow and arrow. Occasionally, my arrow may land on target, but I am exposed to a lethal and toxic environment, where eating, breathing and sleeping my struggles becomes the norm. A place where I daren’t switch off for fear of being unable to switch back on. A cocoon that may appear warm and comfortable on the outside, but is slowly destroying me on the inside.

So, because I was never going to do serenity, I moved away from courage and on to wisdom. The wisdom to realise that the contract was making me drained, cynical and depleting me of joy. And I used the courage to turn my back on it and walk away.

By the time you read this, I will no longer be a partner. The role that 10 years ago was being pursued by hundreds of applicants and I felt so proud to achieve. The role I moved cross country to undertake because it was almost impossible to secure a partnership in the South-East in 2006. In stark contrast, our practice now has unfilled vacancies for three whole-time-equivalent GPs and I know we are not alone.

So in spite of rationalising, innovating and merging, I was unable to shake off the burden I felt on a daily basis. My pessimism was malignant and insomnia the norm, as I lay in bed worrying about my business going under and having to sell my house to pay off the liabilities. There was a nausea that grew over the course of a Sunday evening and I started dreading my job and resenting my patients. The final nail in the coffin was the stark realisation that I felt anger instead of empathy when a GP colleague went off sick. That was the trigger for me to complete a burnout questionnaire; the results were so disturbing I gave notice of my partnership resignation that very evening.

Within a few weeks, people noticed how much more relaxed I looked. My brain started filling with creativity instead of anxiety. Yet although I have saved my sanity, I feel huge guilt for turning my back on the independent contractor status that I still believe to be the most efficient way of delivering primary care.

But I’ve chosen my sanity and I’ve chosen my family. Most of all, I’ve chosen life. Because life is too short and too precious to be a scapegoat for the NHS.

Dr Shaba Nabi is a GP trainer in Bristol

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Readers' comments (53)

  • Do not doubt it, you have done the right thing by yourself and to your partners and patients. Many of us keep turning up at the practice at the start of the week, is there actually an end, because, just because. Many of us used to want/love/need to be at our practice to feel complete but when the want/love/need goes or has gone it's time to leave.
    I left my the practice after 27yrs but it took a prolonged period of leave, doing something completely different to open my eyes and make me realise that I had reached the end of my time at the practice but not in medicine.

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  • Sad to hear it Shaba, best of luck.

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  • Yes, it's best to resign when the work becomes overwhelming as we have to have patients safety our top most priority. Our patients should never be treated by doctors when they become who are tired, exhausted, demoralised, etc as this is not good for both doctors and patients.

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  • Well done Shaba and all the very best to you. At least you are not sustaining this awful system anymore. The more of us that leave our posts/resign the sooner change will be forced through.

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  • Whenever I start to feel like this, I ask myself with which patient of mine I would want to swap places. In 16 years of being a doctor and 10 years of being a GP, I've only come across one patient with whom I would have liked to swap places and he was (still is) an international rockstar. Perhaps we need some perspective.

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  • I too have just resigned my partnership after 11 years. I was feeling the dread seeping into the Saturday night , not just the Sunday and when I couldn't sleep for worry on my week off over New Year , I knew I had to leave. I now work as a speciality doctor in secondary care and could not be happier, even though I am a lot poorer!! Good luck and I hope you find your mojo again!

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  • You have made the right choice, a difficult decision no doubt, but one which will probably save your sanity. I was a partner many years ago and wouldn't go back to all that extra stress again for anything.

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  • Well done - q18 /12 post partnership still in recovery . Saved my marriage but still recovering from the emotional damage of 20 years in Partnership.
    Get out don't look back - life is so much better on the other side

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  • Well done for doing what was right for you. I really wish you the best for the future. I fear for the future of general practice, when I hear about such doctors resigning, and about the new generation not wanting to take on salaried posts or partnerships.I do hope we do not loose you as a GP, as others have said a portfolio career on your own terms seems to be the way of the future. We really need our leaders to look at how we can change things urgently so that others aren't forced to quit to improve their own health. There has to be a limit set on safe numbers of consultation and adequate time to do prescriptions and admin work for all health professionals in primary care. The job is so much harder than 10 years ago with the complex frail and the amount of work that is expected from primary care.

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  • me too.

    fully understand.

    best wishes

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