We should not be embarrassed by part-time GP work
Pulse editor-in-chief Jaimie Kaffash on how general practice should embrace the value and flexibility of the part-time GP
I’ve got a little riddle for you. A father and son are involved in a car accident. The father dies immediately, and the son is rushed into A&E. The surgeon sees him and immediately says: ‘I can’t operate on this boy – he is my son!’ What has happened here?
If you said it was because the surgeon was his mother, you are wrong. What in fact happened was that the surgeon’s God complex – an essential requirement of the MRCS – was so strong that he was referring to every patient as ‘my child’. He was later employed medical director of the trust.
Apropos of nothing, you might have seen reports in the national media this week by a retired surgeon, who blamed the problems with patient access on the fact that female doctors now exist.
Dr J Merion Thomas said: ‘Of course, women have got to have babies. They’ve got to have time to bring up their children. What they do is they work part-time and they job share and at the end of the day we have to educate two women to get one full-time equivalent… in general practice, most of the women are working part time and that is one of the reasons why patients cannot get access to the same GP all the time.’
Now, he’s completely correct that the majority of female GPs work less than full time. But, a slight problem for his argument is that two-thirds of male GPs work less than full time (LTFT) too.
I’m not going to spend the rest of this editorial skewering his feeble argument. Dr Louise Clark wrote far more eloquently than I could on how such sexist attitudes still pervade medicine. Equally, the Medical Women’s Federation and Doctors Association UK provided a great response highlighting the real reasons behind problems with access, and the structural issues faced by women in medicine.
As well as hideous sexism, Dr Merion Thomas’s comments contained yet another anachronism – the disparaging of part-time working in general practice. He’s not alone in this. And I often hear GPs push back on the idea they are less than full time.
There is merit in GPs’ arguments. The data published by NHS England fails to capture how long GPs are really working. Furthermore, LTFT in general practice would be full time in pretty much any other profession. Oftentimes, GPs out of the practice would be doing other vital work – either patient or non-patient facing. And yes, caring for family definitely falls under this bracket, for mums, dads or other care givers.
But, for me, it is time for the profession to embrace its inherent flexibility. This is one of the major selling points of the profession. The ability to tailor your working life around family, or take on a portfolio career, or just choose your hours, or work as a locum, are some of the most attractive aspects of the career. That is not to say there aren’t other attractive elements, but it is a positive.
Of course, for the GPs who do work 60 hours, I can understand some frustration. But LTFT GPs – who, to state again, make up the majority of the profession – are not to blame for the problems within general practice. Forcing GPs to work full time, or even pushing them towards longer hours more subtly, will just have the effect of driving more people away from the career.
We need more headcount GPs. These will translate into more full-time equivalent GPs. If they are working manageable hours, it will also lead to happier GPs. The profession should be louder with its proclamations that, yes, the majority of us are LTFT, and we like it that way.
Part-time working in general practice is essential. It allows GPs to avoid burnout, to develop other skills and prolong their careers. Because, unlike some surgeons, GPs can’t be omnipresent.
Jaimie Kaffash is editor-in-chief of Pulse
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READERS' COMMENTS [6]
Please note, only GPs are permitted to add comments to articles
GP “Part time working” is far from what the GBP considers part time. It is in essence perhaps a “normal” FTE when actual worked hours are factored in without the overtime payments. Surgeries are open for 52.5 hours at least during the normal working week so when folk consider that you can’t see the gp you want on the day and time you want as evidence that, that GP is part time then perhaps they may be disappointed when they try and book a private GP appointment too 🤔
Yes we should be embarrassed as it is one of the causes of the failure of primary care. It destroys continuity of care, and is stopped flexibility is dealing with surges in demand and undermined our commitment to the practice as a vested interent. A cause is we are not paid to see patients directly, as we are in Australia. The more you see and the MORE YOU SO for patients the more you are pain. Zero paitients seen is Zero pay. There is no incentive to work full time to see patients here. Full time to me would be four long days a week. Gerry Bulger… very part time GP.
As recently as 2012 I was told that only a ‘full-time’ GP was a proper GP. I was turning up an hour earlier than one other partner, working through lunch, often delayed leaving on the ‘half day’ even when it was not my turn to stay covering, and leaving ‘on time’, but that was 1-2 hours later than the partner qho could not get up in the morning either.
I had requested to cut down to 4 full days per week (not including weekends, when I was the only one of us doing community medical stufff on weekends.
I was also told that when partner retires, we should seek female GPs to join so that ‘we could take advantage of them’ as long as possible – by which the context suggested we should have them on low and slow parity, despite this being probably in breach of the MPC rules at the time.
I lost respect for the partners who said such things.
The concept of part time in General Practice needs to be represented better to the public at large. Most of my female/male colleagues worming a ‘part time’ post of 3 days (6 sessions) are working as many hours as people elsewhere in the public or private who would indeed be considered full time.
With those statements I thought this J Merion Thomas might be some sort of fictitious character from The Handmaids Tale, but when you google his name turns out he is real and prone to writing the occasional opinion piece for The Daily Mail……..
great article. As a 6 session (4 hour a session) GP I do at least 1-2 sessions admin on top of this. The hospital acknowledge this by PAs.
Some of my surgical hospital consultant friends who are ‘full time’ do an operating list a fortnight, or a week if there is capacity, some clinics, some ward, then ‘PAs’ and work less hours then us, yet the media do not portray these as lazy part time doctors. It is all perception. So now when someone asks what I work, I say full time and don’t get bogged down in session numbers. We need to just have more self confidence as a profession.
Dear Editor,
Your editorial makes a compelling case for embracing part-time general practitioner (GP) work as a cornerstone of flexibility in general practice. However, while flexibility is a strength, the unreserved promotion of less-than-full-time (LTFT) working overlooks critical challenges that warrant deeper consideration.
General practice thrives on continuity of care, which fosters trust, improves diagnostic accuracy, and enhances outcomes for chronic conditions.
Widespread part-time schedules, particularly with job-sharing or locum arrangements, risk fragmenting this continuity, potentially leading to communication gaps or duplicated care.
While LTFT GPs are skilled and dedicated, the editorial underestimates the qualitative impact of reduced patient contact hours on expertise development. Full-time practice, with its broader clinical exposure, sharpens diagnostic acumen and procedural confidence, which is vital for managing the diverse demands of general practice.
The editorial also sidesteps the arithmetic reality of workforce capacity. With NHS England reporting a 4,000 full-time equivalent GP deficit in 2024, training two part-time GPs to cover one full-time role strains an already stretched system. This inefficiency exacerbates patient access delays, undermining the optimistic portrayal of part-time work as a panacea. Moreover, while part-time roles may mitigate burnout, even LTFT GPs face high stress due to intense workloads and systemic pressures. Promoting flexibility without addressing underfunding or administrative burdens risks perpetuating these challenges.
Normalizing part-time work, while appealing, may also deter systemic reforms needed to make full-time practice sustainable. Overemphasizing LTFT roles could signal that deep, full-time commitment to general practice is neither feasible nor valued, potentially discouraging new entrants drawn to the profession’s intellectual and relational depth.
Part-time GP work is a vital option, but it should not be framed as the profession’s defining virtue. A balanced approach, supporting both full-time and part-time roles while investing in structural reforms, will better ensure robust, accessible, and expert-driven care for patients.
Sincerely,