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Undermining of general practice must be addressed, study warns

The NHS must urgently address the undermining of general practice within the medical workforce so that trainees are not put off a career in GP, a study has warned.

Foundation doctors and specialist trainees reported hearing negative comments about the value of general practice from trainers and senior colleagues, as well as comments about their skills being wasted if they took up GP as a career.

It comes after RCGP chair Professor Helen Stokes-Lampard recently said that although GPs do need to vent their frustrations, they should do so only when in the company of senior colleagues. This followed earlier suggestions from the RCGP for medical schools to crack down on negative ‘banter’ against general practice as a profession.

The study was carried out by researchers at the University of Newcastle and the Durham Tees Valley GP Training Programme, who asked just over 1,200 foundation doctors and GP specialist trainees whether they had heard negative comments about general practice during their training, as well as carrying out focus group interviews.

They found that 6% of foundation doctors who responded had received negative comments about the profession, as well as 4% of GPST responders.

Focus group studies revealed that doctors from acute settings in particular tended to view the GP role as ‘simple’, with GPs perceived as not using or possessing the same skills as hospital doctors.

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Other themes that arose from the focus groups and surveys included general practice being a waste of skills and training, the workload being too high and general practice being a less prestigious specialty that trainees ‘end up in’ or ‘fall back on’.

Some trainees reported initially being influenced away from general practice as a career due to negativity and ‘GP-bashing’ from colleagues.

The authors note that the majority of responders reported positive comments but warn that the NHS must urgently address the negative perception of general practice.

They said in the paper: ‘Undermining of GP, and we would extend this to “tribalism” within the medical workforce in general, must be addressed urgently and cohesively within the NHS and training facilities with a “zero tolerance” policy.

‘In addition, increasing time spent in GP as a medical student and foundation doctor, with positive role modelling, would appear to increase the likelihood of trainees becoming GPs. The move to a single GMC Specialty Register and title of “consultant in primary or community care” may also improve the prestige and respect of GPs among their colleagues.’

A study by Warwick Medical School earlier in the year found that 56% of GP trainees felt that negative portrayal of general practice politcally and in the media had negatively influenced their future career intentions.

BMJ Open 2017; available online 3rd November