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In praise of ‘negative’ thinking

How are you feeling right now? Hassled? Thought so. But how are you really feeling? You know, about life in general?

It is one of those questions that sorts the half-fulls from the half-empties. The Tiggers from the Eeyores. The Pollyannas from the Victor Meldrews.

And whichever side of the fence you are on, the ones on the other side have got it wrong. Those on the greener side shout: ‘You are dragging us down!’ while their gloomier counterparts roll their eyes and retort: ‘You need a dose of reality’. This is a divide that surfaces regularly in general practice.

Just last month, the RCGP chair told her colleagues ‘if you want to vent, don’t do it in front of a trainee’, her justification being that all the negativity around the profession is putting the next generation off. To be fair, she prefaced it by saying the anger is understandable in the current climate and I’ve heard similar arguments before, from education leaders and from trainees themselves. Perhaps predictably, it met a cynical response from some.

Who’d want to join a profession of Private Frazers?

A recent study did show negative messages were filtering through to GP trainees, although they blamed ‘soul-destroying media coverage’ and ‘GP bashing’ by the press and politicians, rather than their careworn colleagues. And this may well be a concern; after all, who’d want to join a profession of Private Frazers?

But I can’t help thinking that the truth is a bit more complicated. After all, GPs are trained to be sceptical. In a way, they are similar to journalists, always looking for the alternative angle, the real reason behind something, rather than what is being presented. That makes them a frustrating group to shepherd – something akin to herding felines – but it prevents patients from having a CT scan every time they consult with a headache.

And given the evidence of how the profession has been treated over recent years, the simmering anger many GPs feel can boil over in online forums and face-to-face meetings, and – yes – perhaps on the odd occasion in front of a trainee. The question, as so often in medicine, is does it do more harm than good?

I am a big fan of Oliver Burkeman and his book The Antidote. If you have not read it, then – optimist or pessimist – I suggest that you get a copy. It looks at the dangers of positive thinking, examining how optimists constantly set themselves up to be disappointed. They often ignore the evidence in front of them and, by trying to avoid life’s inevitable uncertainty, insecurity, pessimism and failure, end up less contented, not more.

This ‘negative approach to happiness’, as Mr Burkeman calls it, is not an argument for painting everything black – that is another form of avoiding reality – but it does make the case for dissent when told all is rosy. When I look at my own profession there are many negatives (I could give you a list) but the core of the job is good. General practice is no different.

As ever, there is a balance to be struck, but GPs should be proud of their history of being non-conformist. It is a great strength, and the healthy realism that goes with it must not be airbrushed out in any rush to bathe the profession in sunshine. 

Nigel Praities is editor of Pulse