When I came into general practice 23 years ago, we were four doctors and two nurses working from two consulting rooms.
We are now five partners, two trainees, four nurses and two healthcare assistants working from nine consulting rooms and two treatment rooms. Our list size has increased by 10% in this time.
The number of treatable conditions, and the drugs with which we can do this, has increased enormously. Workload has shifted from secondary to primary care. Blood samples are done in surgery.
The specialists have transferred to us responsibility for managing asthma, COPD, diabetes and warfarin control.
We do in-house joint and tendon injections for the orthopaedic surgeons as well as Oxford hip and knee scoring.
Minor surgery and dermatology are regular sessions here, as is family planning, antenatal care and continence treatment.
I used to ask nurses to take bloods for me; it is now nurse specialists who give instructions to GPs.
Radiology, with the advent of the Picture Archiving and Communications System, has become an instant diagnostic tool, allowing us to bypass the expertise of the radiologist.
Referrals to consultants require use of the clumsy Choose and Book system – and can anyone explain to me why the entire UK population can use eBay and Amazon with no training whatsoever, yet the ‘cleverest' 5% of the population require additional training for this ghastly system?
We are now ‘incentivised' – or in other words, we will not have a proportion of income docked – to reduce our patients' attendance at A&E, thereby increasing our own workload. Surely it is up to A&E to redirect patients as they arrive?
The only thing that has not changed is that we still run to 10-minute appointments. At what point do we as a profession say enough is enough?
From Dr Neil Fraser, Sherborne, Dorset
