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GPs buried under trusts' workload dump

Snowflake GPs? It's what the NHS asks for

Copperfield 

It’s a well-known fact that Eskimos have 100 different words for ’snow’.

We could have done with one of them the other day when we were all having our post-surgery caffeinated catharsis. One of my colleagues was bemoaning the fact that young GPs seem so much less committed to the cause these days, which might just sound like the irrelevant and dying croak of a sauropod, until you realise that my partners, most being roughly half my age, are in fact of the Millenial, rather than Jurassic period.

So, of course, we spent the next half hour trying to avoid the word ‘snowflake’. A good thing too, because, while it might seem that the youngies simply aren’t prepared to put in their hours in the trenches, the truth is rather more nuanced. Consider, for example, the USPs of general practice as routinely trotted out during any recruitment drive, and God knows there have been a few. Such as:

  • It offers flexibility and is therefore a good fit for those with family commitments
  • You can pursue other specific clinical interests – for example, by becoming a GP with a special interest
  • It has a better work-life balance than many other medical roles
  • You can construct a portfolio career, developing interests and skills in various areas as diverse as research, leadership and sports medicine
  • There are more part-time options than in hospital posts
  • Out-of-hours and weekends are optional

Come to general practice because it’s probably the best job there is, not because it’s something you can dabble in while fannying around with other projects

And so on. All of which could be paraphrased by saying that the really great thing about general practice is that you can spend lots of time not actually doing it. And the implication of this is that the core job must be awful to make you want to escape it so much.

So we make lack of commitment part of the appeal, and then spend much time wringing our hands over why new recruits seem less committed.

Now, I know this is going to sound rich coming from me. But the truth is, I love this job. No, really. This is not a stroke/lobotomy/psychosis talking. I wouldn’t do anything else.

True, there are lots of epiphenomena that conspire to ruin most days (micromanagement, scrutiny, bureaucracy, appraisal, revalidation, paperwork, hospital dysfunction, NHS 111, CQC, reorganisations, patients etc). The job itself, though, is brilliant. I have worked in a factory, as a window cleaner, and as a GP. It’s definitely the best of the lot. It’s intellectually challenging, always interesting and pretty well paid.

Seriously, what would you rather do? There’s nothing outside of medicine that would come close. And even inside medicine, it thrashes all the opposition (although compared with working in a pain clinic or A&E, that’s hardly a contest).

This is what we should be selling to potential recruits. Come to general practice because it’s probably the best job there is, not because it’s something you can dabble in while fannying around with other projects.

So let’s get that message right. And I’ll do my bit by trying not to bitch about all the negatives, even if I have just had a shitty day, which I have, actually. Otherwise, we shouldn’t really be surprised that our cherished vocation, like snowflakes in the sun, is simply melting away.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield or follow him on Twitter @doccopperfield

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Readers' comments (9)

  • Quite right - wonderful job. When you are allowed to do it and not have to sit through team building and suffer CQC visits.The seeing the patients bit is great - I still do 10 clinical sessions and cover my palliative care OOH. That is the rewarding bit. Unfortunately so much now is politics. I am however pretty Jurassic!

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  • Jurassic too but 100% agree the job is spoiled by the epiphenomenon.

    For me and probably most others of my ilk though is the reality is that the epiphenomenon rule the roost with inevitable consequences!

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  • I work as a GP and also GPSI in dermatology. One huge problem is that patients respect for a GP’s opinion is so low. I can see the same problem in both locations and suggest the same diagnosis and management but the likelihood of a patient accepting what I say in general practice is so much lower as to suggest they literally see you as an obstacle to seeing a specialist. What patients don’t realise, is GP’s are specialists, in dealing with early and undifferentiated disease and multimorbidity.

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  • I am nearing the end of my first year post 24 hour retirement. When I did 9 sessions of work, 1.5 were endoscopy, the earnings going in to the pot. I ditched those when I hit 60 and now do 6 sessions of GP a week, and yes, I enjoy it. The interesting thing is that I actually do the same number of sessions that my 25 years junior partners are doing in their 'full time' contract!

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  • come to locumland - wonderful !! i took early retirement after having a dvt in my right arm, and a haemoglobin of 5! four consultants advised me to ease up - but i was single handed. when i approached the health board, their response was "you're either working or you're not - get on with it!" so i resigned there and then. i now do two full days a week, and don't have to put up with all the shit that partners do - i spend all day dealing with clinical stuff, and it's heaven! i'm 69, and still going - still with my dvt and down to one lung !

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  • Well said! Whoaml has a point. Is it because of our RCGP trying too much emphasis on softly snowflake style "consultation skills" rather than hard relevant medical knowledge. Show a skin lesion, give the diagnosis and management and bye. Rather than getting it wrong and asking about their ideas, concerns, expectations and how it affects them socially, psychologically, overthinking it, all the snowflake stuff etc....

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  • EXCELLENT article. well said, and good to see lots of positive comments from traditionalists of which I count myself one. We need to defend this type of primary care which works well and wait for all the epiphenomena to evaporate when they are invariably found wanting.

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  • Agree whole heartedly. Locum land, however is where after 15 years a partner, I headed to 4 years ago, and have never looked back. 4 full days a week, 95+% patient contact. None of the direct micromanagement etc for me, just the clinical role I love and wanted when I headed off to uni many many moons ago.

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  • Whoaml. in general , when the patient has seen you a few times and know you have got it right before, and also you have treated their family and friends and they know from experience that when you have needed to , you have referred to hospital , then they will begin to 'trust' you. In other words , continuity of care. The very thing they are destroying and of course hospital referrals will go up. Never mind , rant over.

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