As the UK’s attitudes towards work change, Dr Alex Howard says many GP trainees will choose to work part time after qualifying to prioritise their wellbeing
When I saw headlines a few weeks ago that almost two-thirds of GP trainees plan to work part time just a year after qualifying, I was shocked but not surprised. The statistic came from The King’s Fund, which surveyed 318 GP trainees in England and found 63% of them plan to work no more than six four-hour sessions a week.
According to the think-tank, of those not planning to work full time, 78% said the intensity of the working day was the most common reason. The second, third and fourth most selected answers also related to workload: the amount of administrative work (67%), work-related stress (63%) and long working hours (61%).
I am wary of talking too much about stress and burnout as I’m only six weeks into my GP training. At this stage, I am well protected and supported, and, in truth, I have much less responsibility than my senior colleagues. This means that I can focus on the clinical side of the job, without any of the political and organisational aspects of running a practice or having to supervise junior staff.
But from my own experience and that of my colleagues, it is clear general practice is under huge pressure. Burnout affects all jobs with long hours, of course, but the GP profession can be particularly emotionally taxing. We delve into difficult, personal and often sad issues multiple times a day.
Self-preservation
The sense I get from my fellow trainees is that we all enjoy our work, but like anything, too much of a good thing is bad for you. So, I believe there is an element of self-preservation at work with some trainees wanting to work less than full time, for the benefit of their professional performance and their general wellbeing. The European Union of General Practitioners and the BMA state that 25 patient contacts per day is the upper limit of safe. In this country, GPs see on average 37 patients a day. I guess, put simply, a day off helps lower the average number of weekly contacts to a safer level.
The push towards a better work-life balance can be felt across the country. Earlier this year, many UK companies took part in a four-day work week trial, which aimed to increase the happiness and productivity of workers. At the halfway point of the six-month pilot, data show that productivity has been maintained or improved, and many of the companies have already said they will make the arrangement permanent. This could be the biggest shift in working patterns in a century, since the six-day work week became a five-day work week.
But could this apply to GPs? In theory, improvements in technology, such as remote video consultations, could help increase productivity, decrease commuting time and increase patient satisfaction in a less-than-full-time work week.
And much of the change in attitudes is underpinned by a more holistic approach to life across society. People are more open about their mental health and need for self-care, and are less likely to want to drive themselves into the ground at work to the detriment of their wellbeing. Younger generations seem to be even more tuned in to looking after themselves. Research suggests more than a quarter of Gen Z (those born in the mid-1990s and early 2000s) are teetotal, and are more likely to engage in exercise and mindfulness than older generations. Millennials and boomers may scoff at our sober counterparts, but Gen Z might be onto something.
After I qualify as a GP, I personally plan to work full time. However, I can understand why some of my colleagues may not want to. I celebrate the fact that GPs can have control over how much they want to work, and I believe the flexibility of the profession should be championed. I also feel positive about the job because we GPs are fortunate to have work – and this cannot be underestimated in a cost-of-living crisis, when so many people struggle to make ends meet.
Ultimately, there are many societal and situational factors that may lead trainees to work part time after qualifying. But the King’s Fund research demonstrates that doctors must guard against burnout and unsafe practice themselves. Considering the plan to recruit more GPs and the record number of GPs applying to training, I hope they will be supported in doing so.
Dr Alex Howard is a GP trainee in Leeds
Do not worry. You do not need to prop up this juggernaut system. Let it crumble at the doors of the politician. They planned for it completely – working at scale and the US-sell off. Procurement is in full swing. Entirely – self-preservation, self-worth and awareness of the faecal show and cover-up is not what NHSE has prepared for stupidly. It thought that the workforce would remain as naive cowards and altruistic good-doers, and merely bend over backwards to the put the “patient first” forever under managers and standard policy. They thought the vocation will take you to your grave in service. Never to look up and smell the dirt and shadows on the wall. Well, how about smell the roses. We have all hopefully learnt how this sick system is truly operating, on fake promises, scapegoating and back-handers. The blame game is cheap and the universe is doing it’s rounds on all those who are on the inside job. Most have run away – but they will be caught up with soon enough.
Go plant some tulips – they’ll be prime for Spring.
To get competent, to get comfortable in the job, you need to see lots and lots of patients, and follow them up.
Reduced hours and shift working mean that you finish hospital with less experience than doctors in the past. Meanwhile, GP has got a lot more complex – multiple morbidity elderly, new treatments, hospital dumping, ever increased bureaucracy.
Then the RCGP has done it’s best to minimise your patient contact; as if reflective templates are going to help ffs.
Going part time is a very bad idea if you ever want to get competent in the job, to be more than an Amoxicillin dispenser, protocol drone and the prevaricator who does a blood test rather than make a decision, hoping that the patient will see someone else when they come back for the result.
Please can we stop the narrative that 6 sessions is part time once qualified?
It’s around 33-36 hours
Yes Shabi:
1 session – sticky plaster, remotely interested
4 session – part time portfolio
6 session – full time
10 session – need a hobby, no – cpd doesn’t count
12 session – you need a window
I am a very old GP. At 68 and still working I have a very different perspective and experience of general practice.
I work far harder in my private practice ( Psychiatry) and am exhausted at the end of each day, but I am not stressed, nor am I unhappy. Yet, my NHS work is light by comparison yet highly stressed. The difference has nothing to do with money and everything to do with organization.
In my private work, I organise my administration. My medical secretary supports me as I would wish. My referrals and letters are simple. I dictate, she types, and things happen. In the NHS, it is overly complex, overly regulated, overly managed.
Medicine is fun. It is satisfying. It isn’t difficult.
Recognize that you enjoy medical practice, that you enjoy helping patients. Recognize that what you are not enjoying is the NHS bureaucracy and do things differently.
I am amazed that people who are so intelligent as to get into medical school are so compliant. Practice medicine in a manner that gives you satisfaction.
Steve
36 hours is full-time for sales assistants and secretaries.
Part time in the surgery, doesn’t mean part time overall. The trend is having a bespoke career. OOH, GwSpI, another career / vocation. I would advise everyone to adopt a side hustle as your pension will not be worth the paper it’s written on!