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At the heart of general practice since 1960

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Dr Michael Dixon answers the Pulse careers questionnaire

What/who made you decide to go into general practice?

I have always been a butterfly. I like the unpredictability and comprehensiveness of general practice. When I was a child I used to spend all my pocket money on Jamboree Bags, which you could buy for a shilling and which contained a mystery assortment of sweets and toys. Hospitals never appealed because I would never spend my life looking at just one part of the body or disease and I have always hated institutions.

What would have done if you hadn't been a doctor?

Prior to my medical degree I did a degree in psychology and philosophy and was fully intending to become a clinical psychologist until I spent an inspiring month in a missionary hospital in Zululand run by Anthony Barker. The sheer romance and importance of everything they did made me decide to embark on a medical degree with the aim of becoming a missionary doctor myself. When I first left school I wanted to be a civil servant having watched on television The men from the Ministry and seen how they ran circles round the Ministers. So when I was sent a careers form I ticked the box labelled The Ministry. Initially I was perplexed as to why a person who subsequently gave me a careers interview was wearing a dog collar. So I nearly ended up in the church and some people in the practice call me The Vicar as they think I concern myself with all sorts of things that are not strictly medical. I think it happens as you get older and know patients better.

Who's your career role model/guru?

There are probably three. Anthony Barker in the Zululand Missionary Hospital got me going and a visit to Julian Tudor Hart's practice in a very deprived valley in Wales showed me how you could be a missionary in this country. I was fortunate to do my house surgery job in Exeter and came across the Exeter vocational training scheme run by Denis Pereira Gray, which confirmed to me that general practice is the most difficult job of all to do well ­ and thus the most interesting.

What's your career high-point?

In clinical terms, it was the private satisfaction of a correct difficult diagnosis or successful resuscitation. In my interest in commissioning, it was in 1997/8, when both major political parties supported the development of locality commissioning pilots, which some of us had been developing during darker years. Perhaps my highest point so far was when the Prince of Wales visited our surgery a couple of years ago and he had no sooner entered the surgery than our cleaner, who had just had an operation on her varicose veins, pulled up her dress and revealed the beneficial effects of aloe vera!

And the low-point?

In 1993, prior to my first three months' sabbatical/prolonged study leave, I had become burnt out after 10 years in general practice and began to dread the next patient coming into the consulting room. Apart from three months off, two things saved my life. The first was an increasing interest in complementary medicine and having a much wider range of things to offer patients and different means of approaching their problems. The second was my increasing involvement in the 'commissioning movement', which aims to empower GPs as local leaders and provide them with a means of making a difference without becoming zombies following the next Government directive.

Anything interesting on your surgery/office wall?

The first thing you will notice in my surgery are rows of aloe vera plants, which I use frequently for patients with eczema/cuts/grazes/superficial infections etc. On the shelves I have a number of sweet jars filled with different-coloured water. They look nice but I can't remember why I put them there! On the wall, there is a painting that my wife (a professional artist) gave me a few years ago. It depicts a young woman sitting in a medieval city gazing through its gates to the countryside beyond. Some patients and partners interpret it as her being trapped, while others see the open gate as an expression of hope. I frequently use it as a sort of 'ink blot' test for patients to assess their mood. On the wall I also have an iridology chart ­ it is a discussion point and adds colour to some consultations but I think its use is limited.

What leisure interests do you/ would you list on your Who's Who entry?

Not many because my work (which I thoroughly enjoy) seems to encapsulate most of my life. They are gardening or fishing or any excuse to be outdoors.

Dr Michael Dixon is a GP in Cullompton, Devon, and chair of the NHS Alliance

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