My 40 years in general practice have come to an end and it is time to take the stethoscope from round my neck and put it away. But it is the right time to step down.
I really have tried to adapt. General practice has changed over the years, most noticeably from the National Sickness Service model of yesterday to the National Health Service of today, with its emphasis on prevention and tick-box medicine. Can we really put our hands on our hearts and say that patients are looked after any better?
I am concerned by the new breed of GP now filtering through to the front line. Current training does not seem to equip the practitioner for the rigours of general practice. I have heard patients told ‘Your 10 minutes are up, make another appointment’, a registrar telling us on arrival he was only doing a 37-hour week and ‘colleagues’ squabbling over having more calls or a bigger pile of prescriptions to sign than someone else. Even if you can persuade someone to become a partner, they do not seem to have any allegiance to your practice.
One of the many frustrating things about reaching my time in life is watching people make decisions all for the sake of expediency which you know may not necessarily benefit patient care. Patient demand is insatiable and must be managed, but there must be empathetic ways of doing this.
No doubt some reading this will sneer and say it is easy for me to criticise, cushioned as I am by my generous NHS pension. Yes, I am extremely grateful for the public-sector provision that has been made for me, but I know in my heart of hearts that I have earned every penny. How many times have I worked through a day, been on-call and up during the night and then worked through the next day, until my limbs ached and I was overcome by that numb, cold, slightly nauseated feeling of extreme tiredness? How many times have my three sons had to do without their father or watch him arrive late for an event because of his medical responsibilities? How many times has my wife had to juggle looking after the family and answering my calls, never mind how ill she might have felt herself? All this was against a backdrop of working 12 sessions a week.
I shall also be glad to get away from the ever-intruding bureaucracy.
Recently we have been stopped from offering cryotherapy; for 15 years my practice has without incident been treating patients appropriately by this route only to be told last month that the facility was being withdrawn immediately, citing the well known expedient of ‘health and safety’. Our patients are incredulous, angry and confused and I dread what will happen to dermatological outpatient waiting times.
We have also just undergone our CQC inspection (which lasted all of 20 minutes, I am told), but not before one of our senior management team had to spend many hours wading through a ring file of preparation documents.
These are the sort of things I shall not be sad to leave behind, but I will miss my dedicated loyal staff and the patients – those amazing individuals who by their courage, determination and often their downright eccentricity have made the work a privilege over the years.
Dr Charles Traill, Sydenham, south-east London
