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How to make general practice an enticing career

Dr Karim Adab argues that GPs need to show that there’s nothing general about general practice

Hopefully by now you’ve all retrieved your chins from the floor having enjoyed the new promo videos for the NHS England recruitment campaign ‘There’s nothing general about general practice’, carefully re-running them on freeze-frame to ensure that they weren’t some sort of elaborate meta-meme, designed make you look like a fool when your frothing social media rant revealed you to have taken them at face value.

No, they’re absolutely real, and if filling in a form (that you should have put in the bin) wasn’t enough get your parasympathetic synapses crackling, then turning on a nebuliser and touching up someone’s ankle will blow your tiny minds. The films are a depressing representation of the endemic ignorance of what it means - or can mean - to be a GP.

I understand that FY2s were consulted in the making of them, and appreciate the logic of appealing to your target audience. But I can’t imagine a single junior doctor in the country having their head swayed by this nonsense. What’s more, I’d question the wisdom of taking your lead from a focus group with such limited experience of the subject matter.

Our young colleagues need to see contented, fulfilled and properly paid GPs carrying out interesting and varied work

I remember my GP placement in FY2 very well indeed. One emerges confident and bright from the comforting womb of hospital medicine straight into the opening act of Saving Private Ryan. Every 20 minutes comes a new horror, a fresh opportunity to expose your staggering incompetence.  It’s a humbling experience, perhaps even more so than any other Foundation rotation. It’s also something of an amuse bouche to the speciality, as a good tutor protects you from your own idiocy and hand-picks cases relevant to your inability.

There’s been a lot of talk lately of up-skilling allied healthcare professionals, training pharmacists  into extended roles, of impending physician assistants (spare me the euphemistic name change) to the aim of augmenting primary care. But, unless somebody has decreed that doctors are too expensive and disobedient to bother with, we will still need GPs to do doctors’ work.

So why are we not pushing to extend our roles?

If we really want to enthuse our young colleagues, then they need to see contented, fulfilled and properly paid GPs carrying out interesting and varied work, independent of red tape and non-clinical interference. If we’re serious about breaking down the walls between primary and secondary care, then we should be the ones with the mallet.

We need to be able to demonstrate that prospective GPs will be offered new avenues to explore, to extend their already significant skills, and that other people will pick up the dross.

Medical students and junior doctors are not stupid. In recent weeks their spirited, creative, defence of the profession against Government trolls has been emboldening to witness. They have rallied where previous generations have purred and presented their naval-fluff for inspection, hoping for jam tomorrow.

But we need to reach them, to demonstrate the art, to offer proper rewards, not reinforce stereotypes born in medical school and perpetuated in secondary care that general practice equals handing out sweeties and signing bits of paper. Some fluffy bunnies and an unwieldy hashtag just isn’t going to cut it.

Dr Karim Adab is a GP in Manchester

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Readers' comments (10)

  • Answer: Build all the new surgeries in Australia and Canada?

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  • General Practice is the pits - dumping of work, MPIG, seniority,CQC,pensions,Imposed Contracts, sustained pay cuts, penance, the list is getting longer and longer.
    You bright things out there, there are easier ways of earning a living where a simple mistake will not put your lights out.
    Do not become a doctor. If you do, leave the UK. If you cannot, do not become a GP.
    If you are one, try and get out ASAP

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  • Vinci Ho

    Heroes arise in chaotic times(亂世出英雄)
    History is so often about young heroes (自古英雄出少年)
    May the force be with you , Karim

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  • Go private like the dentists. The private GP body to dump the BMA and RCGP and set up alternatives. Let the public run the gauntlet with non doctor supervised noctors and phoctors and then set the fees that the tax payer will part fund in conjunction with co-payments and insurance like the rest of the western world that doesn't force patients to use dangerous and unsafe health care.

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  • Great article. Karim, I think we have trolls down grading the stars rating too. This article is at least a 4 or a 5!

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  • The RACGP in Australia have had a recent Ad campaign. This was their attempt, makes more sense I thought.

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  • Thanks for that rousing call to arms.
    It's so easy to write with lashings of cynicism and fatalism. Well who are the GPs of tomorrow to look to for inspiration? If the system is broken, I hate to say it but maybe the doctors who stood by a let the profession decline have a case to answer?

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  • I agree with the main thrust of the article. I really don't understand why allied professions should be unskilled to do our jobs. To be honest though I'm not sure if I want our roles to be unskilled, as that is just an excuse for GPs to remove work from our consultant colleagues

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  • Drastically curtail brain-dead box ticking bureaucracy; restore clinical independence, raise academic standards.

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