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Who and what would you like to spring-clean out of general practice this year?

I went to a primary school Ash Wednesday service this week.  Clearly this is not a religious blog, but there was a relevant message in the sermon to GPs. The priest talked about clearing out the rubbish - not household waste, but personal clutter, a purging of toxic thoughts cleanse body and mind. 

Whilst two 7-year-olds held open a black bag, he showed us one piece of paper after another with a theme or word written on it. He talked round the theme, then emphatically screwed up the paper and chucked it away. One said ‘lazy’, another ‘thoughtless’. The children roared with laughter as ‘grumpy’ and ‘nosy’ appeared, then got binned. 

There’s a growing cynicism developing in GP land. Colleague after colleague talks about ‘tough times ahead’ and ‘dips in the cycle’. This spring heralds change: commissioning takes over, new QOF targets come in, GPs up and down the country wince and hold their breath. The BMA has been vociferous in its opposition to the change, but there’s a sense that there’s little we can do, the mood is one of resignation.

What themes could the profession throw into the Lenten skip? How, in the light of imposed and unpopular changes, can we cleanse our collective body and mind? Can we, whilst being forced to work harder for less reward, put issues aside and stride on? 

I can imagine a scene at the annual conference of LMC’s. Two worthy local chairs flank an enormous waste basket. One by one, delegates stand up, pronounce the words that make their blood boil, and emphatically fling them into oblivion.

‘Jeremy Hunt,’ screams one GP in the back row, as his paper ball flies forward. ‘Low back pain,’ yells another. ‘Problem lists’ and ‘Atos statements’ follow in quick succession.

I wonder if a clear-out would actually do us any good. Frankly, I enjoy a good grapple. For every GP at conference pelting the metaphorical bin, there’s another one squeezing the paper in their hand like a stress ball. Morally and spiritually, its good to unload baggage but we can’t do this in general practice - we’d just get trampled on. GPs are nervous, and rightly so, but there’s still some resilience out there. I’m choosing to clutch hold of my angst.

Tom Gillham is a GP in Hertfordshire and Specialty Doctor in A&E. You can follow him @tjgillham.

You can follow him on Twitter at @tjgillham