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At the heart of general practice since 1960

Why trauma medicine gives me a real buzz

Dr Phil Brown explains how he juggles his role as a pre-hospital doctor with his ‘day job’ as a GP partner

Name Dr Phil Brown

Age 43

Location Tiptree, Essex

Role GP partner and pre-hospital doctor

Previous experience Environmental health officer

I work as a full-time GP partner, but I can take time away to do other things for a maximum of four sessions a week (as long as I provide locum cover). I therefore work six clinical sessions and one non-clinical session a week as a GP, and two sessions as an associate specialist emergency physician at Colchester General Hospital.

I am also the medical director for the BASICS Essex Accident Rescue Service, the local charity that organises pre-hospital care in Essex, and I teach trauma and life support courses.

Challenges

My partners don’t appreciate me racing out in the middle of surgery to attend a trauma incident, and some of the patients aren’t keen either. In a way that’s fair – why should the other partners keep picking up my patients, just because I decide to go out in a helicopter for a couple of hours?

I used to be on call 24/7 with BASICS, but that’s not really safe or practical any more, given my other commitments.

The work can be stressful at times. Sometimes you’re the first to the scene and you’re on your own with the job. Patients, relatives and paramedics are all looking at you to do something. There’s a tremendous responsibility in those moments.

But what’s worse is getting a call you can’t attend. It’s stressful, saying ‘no’ – you wonder if anyone else has gone out, and whether the people involved will be all right.

Another challenge is switching off. If you’re a paramedic and you have a bad shift, at the end of it you can go back to the ambulance station, have a cup of tea and debrief. In my role, I don’t have time to do that.

I recently attended a case with a person stuck under a train. I spent 20 minutes at the scene and then went home. Minutes after he died, I was sitting down to dinner with my family.

It’s increasingly difficult to practise advanced medicine as a GP. For me to stay at the top of my game, I have to do anaesthetics shifts – a whole day of them each year – and extra courses in my own time. A role like mine is very rare these days, no doubt because it’s so awkward. Sometimes, I think I’d be better off doing this full time, as it would give me more time to reflect.

I’m one of the last four doctors of my kind, working in both general practice and pre-hospital care.

How I got here

I decided to study medicine the day my son was born. I always wanted to be a doctor but I got a B and two Es in my A-levels so I went to work as an environmental health officer instead. I was happy enough but I didn’t feel stretched.

Aged 26, I undertook a part-time MSc in environmental health. Five years later, after several unsuccessful applications to medical school, I was offered a place at the Royal Free in London. Then my daughter came along.

We couldn’t afford to send me to medical school, pay the mortgage and send my daughter to nursery, but luckily the registrar offered to hold my place until we could.

I worked in environmental health in the university holidays to support my family. I burnt out after two years of not taking any time off and had to learn to pace myself. Fear of failure motivated me – having a family meant I had to qualify.

During my elective I went to Basildon ambulance station to work with Essex Ambulance Service. Once I qualified, the consultant who taught me funded me to go on a pre-hospital trauma life support course. They trained me to be an instructor and when I got full registration, at 39, I went on the books with Essex Ambulance as a British Association for Immediate Care doctor.

‘The biggest buzz’

I’ve been in public service all my adult life and my career aim is to help people. I can honestly say that there are people walking around today who wouldn’t be if I hadn’t turned out – and that’s the biggest buzz of all.

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