The GP role is changing drastically. As a profession, we are expected to see anywhere between thirty to fifty patients a day more often than not to deal with multiple health problems, undertake house calls, see ‘urgent extras’, manage repeat prescriptions, and action letters from secondary care. No doubt this will increase in number with the more options that become available to patients. The list of tasks goes on, while funding and resources have stopped.
I have been a General Practitioner now for three years and I have seen a significant change in the role of the GP in this time. Work is continuously being placed into our hands, whether from secondary care, tertiary care or the community itself. In England, GPs remain frontline clinicians but now manage more complexity than ever before. The population is ageing and with this comes increased morbidity, polypharmacy, and demand for resources but also heightened public expectation about what can and cannot be offered.
The impression I got of general practice as a medical student was that the profession was a ‘second choice’, a less desirable speciality, and one lacking in excitement – something echoed by a young Pulse blogger recently. I suspect the impression from our secondary care clinical colleagues is similar.
But this impression has to change soon – 75% of consultations in the NHS take place in primary care and GPs are now central to resource allocation, despite poor recruitment to the profession.
The last ‘holistic’ doctors
The term ‘GP’ has been around for a number of decades; however the role has changed significantly from that of a clinician that just treats minor illness, provides ‘sick notes’ and refers, to a more complex, dynamic role of treating patients with all minor illnesses, most chronic illnesses and managing multiple complex comorbidities in conjunction with polypharmacy, complex social problems and end of life care.
We are aware of services in the community and hospitals and we appear, possibly, to be the last holistic clinicians left. We know a lot of our patients well – what medically they have had done already, what they may want done and what we think they should have done. We negotiate this with patients and try to be guided by the patient, where appropriate as much as possible.
If we can make medical students realise this early on, then we may have more scope of recruiting new doctors into the profession. A name change would be a big help in allowing medical students and even qualified doctors to realise the complicated role that general practitioners now perform.
So I propose the term primary care consultant. This term reflects the role of a GP as someone with detailed knowledge of their patients’ health needs, alongside a comprehensive detailed insight into primary care, its operations, and its critical role within an ever-complicated 21st century NHS.
Any better ideas?
Dr Pipin Singh is a GP in Wallsend, Tyne and Wear.