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How to make general practice an enticing career



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