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At the heart of general practice since 1960

Change the record to attract new GPs

Guest editor, Dr Alex Gates 

This month Pulse has a different flavour. I am among a group of trainees invited to guest-edit the magazine and we are excited to share our collective voice with you. We often see speculation about what the next generation wants or needs, so this is a welcome opportunity to contribute our views.

For instance, the RCGP chair warned recently that GPs should not denigrate the profession in front of trainees. For every negative mention, she said, somebody else has to say 10 positive things to reassure us there’s a future for general practice.

Negativity is destructive yet surely the duty of candour applies to colleagues as much as to patients? Trainees are savvy to the huge challenges GPs face and don’t always expect a positive spin when the pressures are so glaringly obvious.

As a trainee in a community diabetes role in Swindon earlier this year, I was shocked to see so many practices facing closure or unsustainable demand. The jaded GPs I met were not exactly clamouring to congratulate me on my career choice. We are not blind to the toxic national environment, with the Government merrily pursuing seven-day access and placing a GP in every A&E, while practices struggle to give timely in-hours appointments.

The option of part-time work seems conducive to good mental health for GPs 

Dr Alex Gates 

But if we do not counter the negativity we risk a detrimental impact on medical students’ and foundation doctors’ perceptions of general practice. Earlier this year I gave a talk to students from all over the south west at Bristol Medical School; they were brimming with passion and interest in general practice. But in the current environment, will they choose to join us when the time comes?

Perhaps as well as being candid, we need to look carefully at what general practice can offer the next generation and start highlighting that. A Pulse survey of trainees released today shows the majority of respondents rank work-life balance and flexibility as the biggest attractions of a GP career, and view a six-session working week as the ideal. This chimes with the views of my soon-to-be-qualified colleagues and my own: most of us are taking six-session salaried jobs, with no intention of becoming partners any time soon.

I chose general practice because of its array of portfolio opportunities and the chance to develop specialist skills. Critics might label my generation ‘workshy’, but the option of part-time working seems most conducive to good mental health in modern medical practice.

Pulse’s survey shows I am not alone in valuing the flexibility to adapt to the shifting sands of medical practice to ensure I can have a sustainable career as a doctor. This change of culture should be encouraged. As should, in my opinion, the drive to make GP training last at least four years, with support to develop a special interest, and the idea of more trainee time being spent in general practice.

If we sugarcoat full-time general practice and promote it as a sustainable career we are failing to identify the shift in trainee expectations. The mood music has changed but, in the eyes of the next generation, the profession still seems to be dancing to the old tunes. It’s time to change the record.

Dr Alex Gates is a GPST2 in Bath and RCGP Severn AiT Committee lead

This blog was written by Dr Gates as part of Pulse’s special August issue, which was guest edited by GP trainees. The whole issue covers factors that are important to GPs in training and what they think about the future of the profession. 

Click here to read all the news, views and advice articles from our month-long special on GP training

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Readers' comments (11)

  • My advice would be consider strongly the magnitude of any debts that you take on in life; if working 6 sessions allows you to meet your obligations with regards to these then you will be ok.Quality over quantity in all things should be the watch-word; GP is a hard job to do well and those of us doing 9-10 sessions a week are, I suspect, for whatever reason not working with this approach in mind.

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  • As above the expectations are changing. Don't expect a house of the same magnitude your parents' generation of GPs had. Expect to holiday in England not abroad. Realise middle class cars are a waste of money. If education is important have fewer children or move into an even smaller house in an expensive catchment area. Private school is only an option if grandparents are rich. Realise you are a tradesman and replaceable to those who hold NHS budgets.

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  • Change the record? Can I suggest the Sex Pistols' 'No fun'?

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  • Oh dear, just killed a fairy with that post.
    Now someone has to say 10 positive things about general practice just to make it right again.

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  • Vinci Ho

    Simply
    I give you 5 stars for this blog.
    I just completed 22 years in my practice yesterday.

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  • Cobblers

    As a newly qualified trainee I accepted a full time GP Principal job knowing that it was possible to have a good work/life balance as a FT GP.

    My then partner used to do 9am to 10am surgery and, if no visits, used to head off the the golf course and do a round or two and back to do 5pm to 6pm surgery.

    I was none too keen on golf but this lifestyle was then normal. I had time to watch my children grow up and be part of their lives.

    Roll on 30 years and the incessant demand "Me,me,me,me. Now, now, now, now" is such that one is starting often at 8am and goes solidly through to 6pm or later. And the government wants more in espousing a seven day week.

    It is hardly surprising that new GPs want none of that. Six or seven sessions would still be way more work than I used to do in times gone by.

    Demand must be lessened. A discussion must be had. My personal view is the tap on, tap off tech using a credit card or phone app. One terminal in a GP surgery. Minimal cost to GP. Ease of use to patient but it should make them think?

    Those who feel money should play no part should now have a quick think as to how they would reduce the demand that would be easy to introduce and work.

    And to those who cry about the poor patient might I suggest a government scheme to allow say 3 attendances FOC then they get charged too. One less pack of fags equals (maybe) a GP charge.

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  • Part of the blame for all this must lie with Gp's themselves.Why are the same number providing so many more appointments without any increase in funding?
    Do the hospitals do this -NO they get funded for another consultant.Time to start saying no more go to A+E ,for that is where the money has gone!

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  • It's not the record that needs to change - it's the entirely unrealistic expectations of patients, fueled largely by our political masters, who seem to live in a different world.

    Start charging for GP appointments and see how quickly the workload drops

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  • I'd suggest Ghosttown by the specials... great record.

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  • Work as little as possible

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