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GPs see society’s ills sooner than anyone else



As the socio-political landscape shifts under our feet, openly mocking the inadequacy of 24-hour news to keep track, it becomes more and more apparent that the events in the UK over the last six weeks – the most regrettable consequence of which has been the defection of Pulse’s best columnist – have been some time in gestation.  

Teachers, GPs, experts – people are sick of them, and it shows

None of it should have come as any surprise to any of us, yet I’m sure I wasn’t the only one left bewildered by the Brexit aftermath. But the cues were there, right in front of our eyes.

I work in a bi-monthly gerries clinic under the guidance of a consultant who can only be described as a totem of medicine, a ninja-genius armed to the teeth with all of the old-school idiosyncrasies that Modernising Medical Careers was designed to beat out of its charges. The kind of big beast who would casually tell management to get the hell out of his ward, and in the very next beat make a diagnosis of PSP just by watching the patient eat a yoghurt (this actually happened).

Aside from enjoying the opportunity to soak up these arcane secrets it’s a welcome change in scenery. It feels a little bit like how people describe going to New Zealand: a portal to another time, a different place where people are respectful, polite, yes perhaps even a little deferential. It’s a cocoon from the rest of the hospital which is a dead-eyed, corporate place, where as an SHO I remember feeling straightjacketed, my learning and creativity snuffed out by mind-numbing protocol.

Other than the intellectual challenge that, let’s face it, isn’t always available in general practice, it’s just great how nice people are to the staff. Please, thank you, smiles, that sort of thing; a far-cry from the scowls and tantrums we too often endure in primary care. Yes, some of that is generational, but the halo effect even extends to relatives who you could well imagine acting out in a different environment.

The truth is that the disarming effect of the big shiny building still overpowers modern societal foibles. Hospital and religious buildings must be some of the few remaining institutions in which people still pay respect to rules and each other, where selfies are anathema and people are willingly put a lid on their raging ego. 

Out in the community, of course, it’s different. GPs are one of society’s bellwethers and our consultation rooms are exquisitely sensitive barometers of prevailing trends. We see social problems sooner and more acutely than almost anyone else. Loneliness. Isolation. Anxiety. Financial and educational poverty. For years we’ve witnessed the creep of a general dissatisfaction, a souring of attitudes settled over our little empires like Victorian smog, pervading every nook and cranny of society regardless of man or means. Teachers, GPs, experts – people are sick of them, and it shows.

The Brexit leaders’ belching endorsement of anti-intellectualism cannot have come as any surprise to us in the swampy low-lands, because this way of thinking has been apparent for some time. People are unhappy and this unhappiness manifests in myriad different ways. Add in the deeply ingrained and very British trait of a natural distrust for authority, and there goes both baby and bathwater.

We could speculate as to the various reasons all day, but even within the profession we have suffered for this erosion of authority and laxity of the traditional hierarchical structure. It makes me nostalgic for a time when the big beasts roamed the Earth.

Dr Karim Adab is a GP in Manchester