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General practice may have ‘failed as a profession’, but we have succeeded as a charity



I have had a little think about Professor Steve Field’s pronouncement that we’ve failed as a profession, and what exactly it might mean, and have come up with a slightly different (and perhaps eccentric) take on the whole affair.

Obviously Professor Field has singled out general practice, not doctors in general, so what is the difference?

Let’s compare a few other professions. Supposedly the oldest profession, prostitution, has (apparently) hoards of people thronging to the professionals proffering huge amounts of money for services. Lawyers have hoards of people thronging to proffer them large amounts of money for services. Private medical practitioners (and even ‘alternative practitioners’) have hoards willing to pay huge amounts of money for services (including some that GPs mostly think are unneccessary).

So, in fact, Professor Field’s pronouncement is high praise indeed

Then we come to GPs: have we thrived as a profession? Do we have hoards coming showering us with money? Let’s go through the potential hoards:

 – Patients – no, and if they did, we would be required to refuse it and inform the GMC.

 – LHBs/PCTs – no, indeed, a recent offer of money for referrals, we were urged by RCGP to decline as it was ‘immoral’.

 – Drug companies – well, there is another one we have refused to accept for so long, I don’t think they bother any more.

But we do have many agencies coming to us asking us to do their work for free. And we do have hoards of poorly patients coming to us for free treatment, authorisation of hand-outs, certifications, etc. What do they think we are, a charity?

This is not just a frivolous rhetorical question or dismissive offensive remark. General practice may have failed as a profession, but it has succeeded as a charity. Unfortunately, whilst both may have high ideals and standards, the two are actually, very different in certain basic qualities, that make them probably mutually incompatible.

So, in fact, Professor Field’s pronouncement is high praise indeed. It is just that for the many of us nowadays who are working-class breadwinners, it is harder to maintain the charity ideals if we do not have pre-existent financial ‘independence’ to fall back on to ensure the bills and staff salaries are paid at the end of the month.