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Independents' Day

The, ahem, 'doctor' will see you now

Dr Tony Copperfield

Don’t panic! And of course, you won’t. Because, as Prof Stokes-Lampard correctly points out, ‘Emergency Measures’ have become the new normal in general practice – and indeed, in the entire NHS, with hospital black alerts being the default state, even in the lazy, hazy days of summer, which is why they elicit a barely stifled yawn rather than whatever it is the hospital administrators who issue them actually expect from us.

But many other things are the new normal, too. Such as the feeling of dread you experience dragging yourself out of bed every Monday morning, patients routinely bringing innumerable problems to one consultation to punish us for making them wait so long for an appointment, including one symptom which only developed between booking and actually seeing us, and men on my journey home blithely urinating in A12 laybys in full view of passing traffic, which I feel must be some kind of metaphor for the NHS which I’ve yet to work out.

All normal and, therefore, to be met not with resolve, apology or disgust, respectively, but with a shrug of the shoulders.

Which is pretty much the way the public is reacting to the unstoppable trend for having to see, at first point of contact, a health care worker other than a GP. My sense of professional pride makes me want patients to react with fear and fury. But they’re not, except in Wales, and I’m not sure they count.

There are three possible reasons for this endemic patient indifference:

1. They don’t care who they see so long as they’re seen now, and are given what they want, also now.

2. They don’t understand that the move to use advanced nurse practitioners, pharmacists et al in the front line is the result of necessity rather than design.

3. They don’t even realise that consultation they’ve just had wasn’t actually with a doctor, which I suspect is happening more than we’re prepared to admit and may even be a misunderstanding we’re happy to cultivate.

Whichever way you cut it, patients haven’t a clue what’s going on. True, that may be the old normal. But now it feels like we’re complicit, and that makes me feel even more depressed as I drive home back up the A12. Either that or it’s those autumnal golden showers.

Dr Tony Copperfield is a jobbing GP in Essex 


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Readers' comments (8)

  • David Banner

    We all feel we're piddling in the wind these days.
    Our ANP was appointed out of GP recruitment desperation, but in truth I couldn't work without her any more. Having the extra 1st defensive line of triage protecting me from the constant barrage of patient shellfire is the only reason my trench hasn't yet surrendered. When the GP war is linevitably lost, it's nurses like these who will be left to pick up the pieces.

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  • AlanAlmond

    There’s a basic issue here which I think we (GPs) often overlook. Most people (that’s Jo public, the bulk of the mainstream media, and just about every politician other than the couple who are actually qualified GPs themselves) have not the least idea what a GP is. I’m pretty certain if you did the right surveys you’d find a majority aren’t aware GPs work as hospital Drs during training, I’d bet a significant number don’t even know GPs are fully fledged qualified Drs. They dont appreciate what they are getting so they aren’t too fussed who they long as it’s NOW and they are given what the WANT. When we’ve gone it’ll all be crap but the poor buggers won’t have the least idea why. Such is the sea of ignorance in which we swim. We really have not a ice cubes hope in hell. Bring in the tea lady. She’ll do just as good...until someone takes the cuppa she gave them, gets it analysed and finds out it’s a cup of tea and not a weeks course of antibiotics as they’d kind of assumed.

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  • So true--the new normal. All colours of the alerts invented by managers are just met with yawns as we are already at the limits.

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  • AlanAlmond

    ...I have, by the way, the greatest of respect for evey ANP working in a GP role that I have met (a total of one). She was absolutely marvellous and (echoing the first poster) I feel sorry that these poor folk will indeed be left holding the baby with out the support they deserve, when the bulk of GPs are gone.

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  • 2% Think you are a genius, 2% think you are and idiot and the other 96% don't give a monkeys.

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  • I don't think they notice or care.
    OOH was replaced with an inadequate replacement all over the country. Not a murmur of protest. We could all be replaced and only we would know what had been lost. Hunt is canny, he knows this, he has calculated the political cost of allowing us expensive employees to be replaced is very low indeed. I think this article demonstrates he is right in that calculation.

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  • Of course patients will be happy to be see the Nurse instead of the GP, in the same way as they see the trainee. But on their way out they'll still be booking in with the GP so the access problem is not resolved, just postponed.

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  • Patients in Wales don't count? Is that what you meant? Please explain.

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