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Letter of the week: Revalidation will drive GPs into early retirement



I am writing this open letter to Professor Peter Rubin in his role as chair of the GMC to express my concerns over revalidation. 

I have loved my 31 years’ work as a GP and count it a privilege to have served my patients for so long. I am 59 and plan to retire in 2013. I would have continued in practice but I will not, because of the huge increase in unnecessary work that has been dumped on GPs by successive governments, with the collusion of the GMC and RCGP, and with the spineless response of the BMA.

I do not resent the need to work hard; what I resent is the needless work required of me simply to jump through hoops and tick boxes for the sake of political expediency.

Revalidation as it stands is an insult to the profession, and our governing and representative bodies should be ashamed of the extra pressure it is putting on GPs.

I am not against appraisal and CPD – quite the reverse, as evidenced by my involvement in training. But the prescriptive demands of revalidation are unacceptable. I have to take a week of my holiday to prepare for my appraisal – and at my last one I was told that I was not ‘reflecting’ and documenting enough. 

One evening two weeks ago, I sent an email to every GP in Southampton expressing my sentiments. By 7.30am the next day there were seven replies, and since then my inbox has been flooded. There have even been contributions from appraisers who don’t believe in the system. Only one GP tried to defend revalidation, and he had to as part of his job.

Here is a small sample of the emails I received: 

  • ‘I probably have another 20 years left in my GP career but I don’t feel that the next few years are going to be easy. I dread the whole appraisal/revalidation process. I don’t have time set aside to do this. There has to be a better system to catch the Shipmans in this world.’
  • ‘I couldn’t agree more with you. It is clear to me that the whole thing has got out of hand.’
  • ‘I suspect your views echo the feelings of the majority of rank-and-file GPs in their late 50s/early 60s, who are still working but talking about when rather than if they’ll retire.’
  • ‘I am not going to work after the age of 60, for the reasons you mentioned.’
  • ‘I am an appraiser and I have met many doctors in their 50s who are counting the days till they retire. They still enjoy the clinical work but are going to retire because they’re fed up with endless non-clinical work of limited benefit.’
  • ‘At 62, I have decided to retire at the end of the year, not because of the job, but because of all the tick-boxing and ennui that comes over me at every new directive.’
  • ‘Like you, I love the job, and have probably got better at it over the years. I do not intend going on past 60 and, while I would love to keep doing occasional sessions, the nonsense of revalidation will ensure that does not happen. I feel very sad about the way things are going’.
  • ‘I am now in my 68th year, working part time since age 65. I entirely agree that revalidation is complete nonsense and an insult to our professionalism. It puts a huge burden on us, on top of all the challenges heaped on us every year.’
  • ‘I went to a GMC/RCGP meeting on revalidation yesterday. As someone in their middle years, yesterday left me wanting to retire and hang up my stethoscope.’

I haven’t sent you all the responses but I think you get the picture – it seems I am not alone.

Perhaps a full-blown manpower crisis will be what is needed to shake the GMC out of its arrogant certainty of the merits of revalidation.

From Dr Phil Clarke, Southampton