We are in a united state of tension

Copperfield is tense and exasperated by patients’ understandable frustration

‘You seem a little tense’ says my other half as I arrive home from day duty, head butt the wall, scream expletives and reach for a Copperfield measure of chilled white (i.e. start chugging the whole bottle). Well, that’s a result. Most days, I’m a big tense.

Being GPs, at any given time, I reckon we’re always somewhere on that tension spectrum. So is this us suffering the ‘long lasting emotional impact’ caused by patient safety incidents as revealed by the BJGP in their ‘No kidding?’ section?

Nope. Frankly, you’ve got to expect a few cock-ups in your career, and if you escape unscathed then you’re either inconceivably lucky or not seeing enough patients. The real issue is not the acute exacerbations, it’s the chronic condition: a constant state of tension is pretty much written into our job description.

For examples. It’s a miracle that we already work to a 90% level of perfection. Yet secondary care and guideline bodies want to stretch us more, piling on pressure to achieve excellence despite that meaning escalating workload and diminishing returns.

Then there’s the uncertainty we live with to protect patients and secondary care. We manage that burden and have to shoulder the consequences when it blows up in our face. And with that comes the further tension of trying to avoid over-defensive medicine while remaining medico-legally watertight.

All this within a system that seems to have infinite capacity for promising, assessing and monitoring but sod-all ability for delivering, which understandably leaves patients frustrated and us exasperated. The professional hand-wringers cause this moral injury. But I hate this term because a) It’s inflated and self-martyring and b) It doesn’t really convey the state of hypervigilance required by us being the only accessible human face of the NHS, and one that can therefore be stoved in by a disgruntled punter. Maxillary injury, maybe.

So yes, I’m a little tense, maybe more, maybe even beyond tense. And so past tense. As we all will be if we have to keep this up.

Dr Tony Copperfield is a GP in Essex