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No one likes us – and we don’t care



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Absolutely tragic news for those of us, that is to say, that minority of us, that is to say most definitely not me, who have a deep-seated need to be liked/loved by our patients. Because they aren’t any more. According to the National Centre for Social Research’s British Social Attitudes Survey – and if there was ever a survey on our attitude to survey titles, this would not score well – satisfaction with GP services has plummeted in the past year.

Satisfaction has dropped from 72% to 65%, the lowest level ever. It means that, for the first time, we’re not the Manchester City of the Health and Social Care Premiership. Instead, we’re level on points with outpatients. Yeah, I know, outpatients: a service characterised by incomprehensible consultations, unavailable test results, zero continuity, late running and parking fees. We’re that bad.

Those who could be bothered to raise even half a sceptical eyebrow at this finding were quick to rationalise away its importance: it’s not GPs who have fallen in the public’s estimation, it’s the service in general, and that, of course, is beyond our control. Besides, the public is becoming ever-more critical, demanding and unforgiving, with the older, more grateful and more graceful cohort these days only able to show its appreciation in the form of crem fees. And anyway, it’s pretty obvious the slump in satisfaction simply reflects the prevailing culture of everyone hating everything and everybody more than they used to. Etc.

All of which is probably spot on. On the other hand, the stats might also hide an uncomfortable truth, one that is difficult/embarrassing to articulate. It goes something like this: patients are less satisfied with the GP service because the GP service isn’t as good as it once was, and that’s because GPs are less committed than they once were.

GPs are no longer the Man City of the Health Premiership; we’re now level with outpatients

I genuinely believe this to be the case, and dismissing it as the terminal roar of a burnt-out dinosaur doesn’t necessarily make it any less true. As far as I’m concerned, there has definitely been a fall in dedication and goodwill, a general dilution and anonymisation of care and a decline in, or even scorn for, ‘commitment’.

There are doubtless all sorts of excellent reasons for this, including, off the top of my head, the realisation that there’s a life outside general practice, a move towards more corporate and faceless structures, an awareness that the pact between GPs, NHS and patients has broken down, an increasingly rigid and militant approach to contracts of all sorts, the relentless grind of workload and medicolegal peril, the all-pervading need to wear resilience as a badge of honour and so on, ad nauseam.

So maybe our slide towards mid-table ignominy in the satisfaction rankings represents an opportunity to point this out: perhaps, ultimately, society gets the doctors it deserves. In other words, we care less, and may reach a point where we couldn’t care less, and that’s because we have lives, too. Saying this might not make me popular but, hey, I’m getting used to that.

Dr Tony Copperfield is a GP in Essex