Dr Dom Patterson – online 330×330
Are we GPs stupid? I wonder sometimes. There’s a massive shortage of us, yet many seem to be doing everything we can to put off prospective colleagues.
We need as many GPs as we can get. If we had more, the job would be easier, struggling practices might survive, GPs who are burning out would be better supported. The alternative models of care – for example physician associates, so dreaded by some – might not be inevitable. Patients might be safer.
I understand the reasoning. How can we tell the next generation they should join us when we are struggling so much? And I respect it. I just think it is foolish.
These are adults who are perfectly capable of weighing things up and making decisions about their future. I was chatting to our medical student last week. She felt patronised by the idea that we might tell her not to do general practice because it is too hard and not rewarding. She made the point that nobody comes into medicine expecting it to be easy, that they are all prepared to work incredibly hard. She knows that all specialties have positives and negatives. She wants to know the reality of the downsides, but she expects them, and is more likely to make a decision based on the positives, not the negatives.
I do think we have a duty to be honest with those considering general practice. But that means we must give them all the facts, not just those born out of our pain. And while we must be careful not to sugar-coat things, we mustn’t shit-coat them either. We need realistic positivity.
So give them the balanced truth and grab as many of them as we can and don’t deny them the privilege of this career because you’ve forgotten what you loved about it. If they are drawn to the positives, let’s get them on board and work to make sure that things are better.
Of course, those of us elected to represent the profession need to argue for better working conditions, more resources and overhauled regulation. But all of us need to wise up. The cavalry won’t come if we take every opportunity to tell them of the futility of the battle.
Dr Dom Patterson is a GP in Yorkshire, RCGP council member, deputy director for postgraduate GP education at Health Education England Yorkshire and the Humber and the instigator of the #whyGP campaign.
Dr rebecca jones square
As doctors, we are taught from an early stage that probity is as important as our clinical ability. The most basic level of my argument lies on this principle; if GPs were to be dishonest about the reality of their working lives, this would surely jeopardise our professional integrity, and I, for one, would not be able to tick that ‘No’ box in the probity section of my appraisal.
In the same vein, we are taught that any decision made by a patient needs to be fully informed. In other words, the implications need to be comprehended before they make a decision that could affect their life, even if this is negative or difficult. Shouldn’t this principle spill into our role as mentors and trainers? Would it not be unethical for us to lure medical students into a very difficult way of life without informing them of the reality?
Even without these ethical and moral implications, there is a bigger issue that underpins all this. General practice, and perhaps the NHS as we know it, is on the verge of collapse. GP trainees should be taught more about medical politics – we have little chance of changing things for the better unless we are aware of how to do so. And before a GP reaches the point of wanting to get involved in politics, they need to appreciate the problems and the impact they will have on their professional and their personal lives. We are all very aware of the late finishes in the evening, the sleepless nights and the anxiety that come from working as a GP. Why don’t we equip our trainees with knowledge and skills to combat the issues we face?
So, I am arguing for honesty and transparency, but this doesn’t mean we can’t shout about the good bits. There are reasons why we are all still here, fighting for a better service and a better working life. Whether it is the intriguing case that leads to a satisfying diagnosis, or the wonderful relationships that can be formed with our colleagues and patients, there is something worth fighting for. So let’s be honest with our trainees, tell them how hard it is, but encourage them to help us change things for the better.
Dr Rebecca Jones is a GP in Hastings, East Sussex and AiT/new GP representative for GP Survival