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Giving undue influence to patient opinion risks crushing GP morale

There have been numerous surveys and opinion polls in the country enlisting the most preferred profession and the most trusted professionals. Doctors have always come out winners and family doctors have been the most trusted professionals. Does such a highly trusted cadre of professionals have any organisation or guardian angel to look after their welfare, safety and prestige?

The obvious answer is ‘No’. In fact, the profession has been reduced to a laughing stock thanks to its own stewards. Any patient can complain directly to the GMC, bypassing all established channels of communications. General practice has an effective practice-based complaints procedure wherein complainants can seek to ventilate their grievance to the practice managers, who are in the best position to redress a complaint. Through that route there would be only a fraction of complaints relating to medical negligence and need to be directed upwards. A rise of nearly 23% in complaints this year is a silent testimony to this fact.

Patients’ complaints received directly by the GMC are re-routed through the practice or the PCO. The GMC starts its investigation through Fitness to Practice panels. Besides being a colossal waste of time and effort, this causes untold harassment to the already stressed GPs. The profession is in dire need of an organisation that can ameliorate its stress and act in the best interest of doctors – and not patients alone.

The medical profession is riddled with instruments that only add to the doctors’ woes. The latest example is the assessment of GPs by their patients who are invited to grade whether a GP is ‘Poor, Poor to Fair, Good, Very Good, Excellent or Outstanding’. A patient is in judgment on whether a GP made them feel at ease, being asked: did the doctor let you tell your story, was the doctor really listening, and were they really interested in you as a whole person?

As if that was not enough, the judicious patient is further asked to comment on whether the doctor was fully understanding their concerns, was showing care, compassion, being positive and explained things clearly. To top it all off, they’re asked, did the doctor help you to take control and make a plan of action with you? At the end of a 10 minute consultation a doctor must pass the test when the patient is asked to rate the consultation.

I don’t know how many professions there are that enjoy the same privilege of being assessed by their clients. For doctors this instrument is their latest blessing in the form of appraisals leading to their revalidation. This process requires an urgent and dispassionate reappraisal.

The invention of an electronic appraisals toolkit for revalidation is bound to cause much dissatisfaction among the profession as there are GPs of varying ages and IT proficiencies who will find these electronic games hard to cope with. They will seek the help of their administrative staff, which only impinges upon the time and financial resources of practices already reeling under financial pressure. The exercise appears to be futile.

The profession needs fresh leadership with the vision to steer the boat to a safe future, and not get embroiled with unnecessary bureaucratic wrangles.

General practice is suffering under a hiatus, full of blind directions, pretending to work in the best interest of patients. Will some Messiah come and restore the prestige to the profession?

Surjit Kumar is the business manager of a practice in Chingford, East London