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Dr Heather Ryan: Perhaps I am a masochist, but general practice is worth saving

Dr Heather Ryan

Dr Heather Ryan 3×2 duo

I ought to start by thanking you.

I’m looking for a job at the moment. To say it’s an employee’s market is an understatement; years of neglect have made primary care a deeply unattractive place to work. Gone are the days of 30 applicants for every partnership. Today the typical GP interview has two questions: do you have a medical degree and a pulse?

Job-hunting is a bit like being the most attractive person on a dating website. My inbox is besieged with unsolicited offers, and I’ve had more people show an interest than I could ever physically meet. Just like a dating site, not all potential suitors are an attractive proposition. When I rang one surgery to enquire, I was proudly told that they were ’not motivated by money’, but instead that ‘our patients always come first’. Sadly, I am motivated by money, and, to extend the analogy, I prefer mutual satisfaction in my relationships.

It’s hardly a surprise that practices struggle to recruit. Far from treating general practice as the ’jewel in the crown of our NHS’, as Jeremy Hunt once said, your party has starved us of money: primary care funding, as a proportion of the NHS budget, fell every year from 2010 to 2015. GPs are overworked and demoralised and are burning out and retiring.

In that context, perhaps only a masochist would choose a career in general practice, but I cannot imagine doing anything else. There is something invigorating about being faced with a new diagnostic challenge every ten minutes, with only history and examination to go on. Without the temptation of a lab down the corridor, as a GP registrar I learnt the vital primary care discipline of only ordering a test if it would change my management. Do you realise, Theresa, what excellent value for money GPs are, or will you only appreciate that when it’s too late?

Over the two years that I have been at my current practice, I have built powerful therapeutic relationships with some of my regular patients and their families. In turn, when their health falters, I, as their GP, am in a unique position to work with them to plan supportive care – which usually means keeping them out of hospital. Do you have any idea how much money your Government could save if you helped GPs to keep patients in the community by resourcing social care properly?

My colleagues arrive early, stay late, and squeeze a remarkable amount of work into their often lengthy days. The partnership model means that the financial risk in general practice is borne by the GPs themselves. Theresa, do you think the directors of a multinational corporation will give so much of themselves when their company is running what’s left of primary care?

There’s a lot wrong with modern primary care, but I reckon it’s worth saving, and I look forward to taking on the challenge. Will you help me, Theresa?

Dr Heather Ryan is a GP registrar in Liverpool. You can follow her on Twitter @DrHFRyan