This week’s study that GPs’ ‘gut feelings’ are more useful than guidelines at identifying potentially serious diagnoses may come as little surprise to many GPs. They know that their intuition and ability to spot when something just doesn’t feel right is essential.
But I fear it sometimes gets forgotten how highly skilled general practice is by politicians, patients the press and NHS managers. And this has implications that are being amplified throughout this pandemic.
First of all, the move to remote consultation has been one borne of necessity during the pandemic. And there is no doubt it has had benefits. But a wholescale revolution – as the health secretary appears to be advocating – ignores all the nuance involved. There are arguments for and against: I do think more remote consultation would help with GP burnout if done right, for example. However, it loses a lot of this GP intuition, which may have serious repercussions.
The very nature of referral forms don’t allow for GPs’ intuition
Second, we are hearing more reports of trusts being stricter around referrals, sometimes being overly pedantic around forms not being filled in correctly. I have no doubt this is rationing that may be coming from above. But regardless, the very nature of these forms don’t allow for GPs’ intuition. Yes, there are ways round this, but this should be built into the system.
And finally, it should once again give pause for thought around the move to shift more work to non-GPs. The skills of ANPs, pharmacists, physiotherapists, etc should never be underestimated – but GPs understand that the ‘non-complex’ patients may in fact be complex. There are serious repercussions for patient care if this is forgotten.
Of course, there is more to each of these debates: the lack of GPs is the key driver for bringing in other healthcare professionals and is a big factor in the push for remote consultations. But hopefully this study will refocus minds or at least serve as a reminder of the beauty of general practice.
Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at email@example.com