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At the heart of general practice since 1960

Undermining of general practice must be addressed, study warns

The NHS must urgently address the undermining of general practice within the medical workforce so that trainees are not put off a career in GP, a study has warned.

Foundation doctors and specialist trainees reported hearing negative comments about the value of general practice from trainers and senior colleagues, as well as comments about their skills being wasted if they took up GP as a career.

It comes after RCGP chair Professor Helen Stokes-Lampard recently said that although GPs do need to vent their frustrations, they should do so only when in the company of senior colleagues. This followed earlier suggestions from the RCGP for medical schools to crack down on negative ‘banter’ against general practice as a profession.

The study was carried out by researchers at the University of Newcastle and the Durham Tees Valley GP Training Programme, who asked just over 1,200 foundation doctors and GP specialist trainees whether they had heard negative comments about general practice during their training, as well as carrying out focus group interviews.

They found that 6% of foundation doctors who responded had received negative comments about the profession, as well as 4% of GPST responders.

Focus group studies revealed that doctors from acute settings in particular tended to view the GP role as ‘simple’, with GPs perceived as not using or possessing the same skills as hospital doctors.

Other themes that arose from the focus groups and surveys included general practice being a waste of skills and training, the workload being too high and general practice being a less prestigious specialty that trainees ‘end up in’ or ‘fall back on’.

Some trainees reported initially being influenced away from general practice as a career due to negativity and ‘GP-bashing’ from colleagues.

The authors note that the majority of responders reported positive comments but warn that the NHS must urgently address the negative perception of general practice.

They said in the paper: ‘Undermining of GP, and we would extend this to “tribalism” within the medical workforce in general, must be addressed urgently and cohesively within the NHS and training facilities with a "zero tolerance” policy.

‘In addition, increasing time spent in GP as a medical student and foundation doctor, with positive role modelling, would appear to increase the likelihood of trainees becoming GPs. The move to a single GMC Specialty Register and title of "consultant in primary or community care” may also improve the prestige and respect of GPs among their colleagues.’

A study by Warwick Medical School earlier in the year found that 56% of GP trainees felt that negative portrayal of general practice politcally and in the media had negatively influenced their future career intentions.

BMJ Open 2017; available online 3rd November 

Readers' comments (19)

  • Might help more if media didn’t denigrate, blame or underpay them

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  • Only 6%

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  • I READ AN ARTICLE IN WHICH HAMMOND WAS DESCRIBED AS "DERANGED" AND A "MORAL CRIMINAL" AND I HAVE TO SAY I UNDERSTAND WHY THESE COMMENTATORS VIEW THIS MAN AS COMMITTING "MORAL CRIMES" AGAINST SOCIETY AND SHOWING DISGRACEFUL "CONTEMPT FOR THE GENERAL PUBLIC"

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  • When we are gone they will all have to have general practice skills,as ther will be no shite wall to protect secondary care,it will ALL be dumped on their doorsteps.t

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  • 12 hour days, multiple jeopardy, shrinking pay, out of control CCGs spewing out ridiculous conditions etc etc - the same old stuff add in CQC, devious behaviour over indemnity and try then to make a positive case ....

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  • Vinci Ho

    I think one has to be careful how one defines ‘negativity’ and clearly there are two types here:
    (1) Progressive and aggressive from those who are entirely ignorant of what general practice in the frontline is about . That includes those cynics in the government propaganda media and machinery , as well as some of our arrogant secondary colleagues. Those remarks are purely denigration, disdain and derogation. They do not believe and respect general practice has a value in NHS.
    (2) Reactive and reflective from those actually working very hard daily on the frontline. The negative reality ,created by our politicians and leaders ,is what we actually can observe and experience. In fact , those in (1) are the fire-starter for our responses on this platform.
    Like Stephen Hawking wrote in his book Grand Design:
    ‘We create history by our observation, rather than history creating us.’
    As I always write , we never want to start this war( of words). Our defence (inevitably perceived as ‘negative’) is our means of survival. Otherwise, some had chosen to walk away .
    And of course , Professor Hawking has a famous confrontation with the Health Secretary about what happen in NHS so far . He was truly critical and arguably ‘negative’ about how the government is running the NHS .
    But would you recommend every junior doctor and GP registrar to cover their eyes and ears to these comments?

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  • Vinci Ho

    But would you recommend every junior doctor and GP registrar to cover their eyes and ears to these comments, specifically his comment?

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  • Should have known better - I thought the headline referred to media spin and funding decisions, not further undermining by blaming us

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  • Cobblers

    They waste money on some studies don't they?

    38 years ago I used to hear views that were denigratory to GP. Mainly hospital colleagues.

    That being said I was set on being a GP. I really enjoyed my stints in GP, as a student, and as a trainee. It had a future and that I could see.

    Now we have denigration by Secondary Care, Media and Politicians and GP currently has no future. The kids can see that too. They do not need to be told.

    So maybe do a study on how to change media and political viewpoints on Primary Care?

    Oh dear those men in white coats are knocking on my door.

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  • Do you know what will attract the young?

    Stop the job being such a crock of s^*t, impossible expectations, workloads and indemnity fees.

    It really is that simple.

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