Six months ago, I left general practice, having recognised that I was highly unlikely to ever find a way to stay well working within the restraints of the current system. I managed to continue to provide a high level of care to my patients only by compromising my own life continually and always teetering on the precipice of becoming unwell.
As a mother with three little girls watching and learning from me, I couldn’t continue to show them that this was an acceptable compromise. I am so grateful to have been able to say: ‘no more’, and was able to step back to consider my future.
From this vantage point, I can tell you that I haven’t regretted my decision for a single second. I’m well. My family is happier. My children are less anxious and angry. I have more capacity to simply sit with them, to play with them and enjoy our time together. It feels like a second chance. I have more capacity for my own feelings. I’m more joyful. I’m more me.
To get to this place though, it hasn’t been plain sailing. I think during the last months I’ve ridden the predictable rollercoaster of the grief cycle and finally found peace with the loss of a career that I loved. In the immediate aftermath, I felt a new freedom, temporarily elated, but soon I became very much like a rabbit in the headlights dazed, confused and raw.
Then came anger and outrage. I spent weeks scrolling through Twitter feeds and consuming newspaper articles fervently outraged by the way our profession was being defaced in the press.
Personally, I was furious that I had needed to leave my job for self-protection and that my colleagues were still suffering in the thick of it and truly, I felt so guilty for abandoning them.
The next wave led me to a deeply reflective place. Experiences from my medical career popped into my mind with reckless abandon and patients from the past dropped into my consciousness. I relived times when patients had died under my watch and finally mourned them years after their deaths. I realised that I had never allowed myself this kind of human reaction while I was there in the thick of it and I wonder whether to some extent this was self-protection; if the floodgates had opened would they ever have been shutable again?
Next, I felt lost and a bit hopeless. What had I done? Would I ever work again? What if I can’t do anything else? And now finally, I’ve settled in this calmer place, accepting of how things are, and am open to explore what is next for me.
The question that still haunts me though is how the NHS, how general practice seems to have become a place of dis-ease for the people working within it. It’s the ultimate irony that the health service does not provide a workplace which supports the health of its employees.
I’ve rarely spoken to another GP who is finding their work life manageable. How can we expect people who are not cared for and protected within their career to compassionately care for others? The sums just don’t add up. Consequently, burnout is rife in our profession.
The resilience distraction is wearing thin. Never could you find a more resilient group of humans than GPs working in service of their patients. Burnout needs to be seen for what it is – an understandable response to adversity. It’s not a problem with the people working in general practice. It’s a reasonable response to relentless environmental and cultural pressures. It’s time to stop gaslighting the hardworking humans working in general practice.
Dr Lisa Finnikin was until recently a salaried GP in Sutton Coldfield
READERS' COMMENTS [15]
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I found this very moving thinking about myself my colleagues and my family.
You are very brave and this will be supportive to many of the people going through the same things as you have gone through.
I am a 62-year-old full-time GP but this moved me to tears.
This resonated with me having left my partnership. Am in acceptance mode. Less money but a less stressed and more fulfilled life. More time for me and my friends and family.
Have so much more capacity to work and care for patients but not if it harms me or my family.
Thank you Lisa
I think we need to stop this word *burnout. It is not helpful, nor does it directly target and address the perpetrators. It isn’t burnout. It is sickness, sabotage and intimidation. It is scapegoating, bullied, psychological manipulation, disrespect, racism, silencing and being hung to dry. No rest or resilience training will change what is an orchestrated offensive disease of professional slavery and neglect. Burnout doesn’t hold the shamefulness and ugliness of it all. But, it is good you found time to walk up the hill and look down.
Thank you Dr Finnikin.
This is very moving and reflects the reality.
Unfortunately we GPs were not trained to speak out.
Will ever change though?
We’re not only under relentless environmental and cultural pressures, also hunted by bureaucrats.
I do miss positivity in the NHS!
This really rings very true to me. I have almost completely left regular practice for locuming. I found the same things as you with my young children. I am so much happier now. I feel constantly guilty for leaving my colleagues short, as they have found it difficult to hire doctors in the last couple of years, but I have accepted that i cannot fix the system by working until I break. Now I can concentrate on my family, and myself, and find where work fits into my life, rather than where my life can fit around work.
All the best Lisa 🙏
This is the message I sent to a younger PCN CD colleague a few days ago👇
‘’Many thanks for your kind compliments which I doubt I deserve .
Reality unfortunately bites six weeks ago when I fell ill with a diagnosis of severe anxiety attacks needing medications, in essence , burnt out . I had to resign(PCN CD) with advice from my own GP . I am currently signed off sick .
My insight , on looking back, reflects and signifies risks associated with the life of being a CD , especially if you are isolated in a less organised( or absent) management infrastructure with adept colleagues to support your leadership.
PCN remains a contentious ideology to take us forward , if you look at currently opinions among GP colleagues . This is further complicated by rather unrealistic expectations from the government (and perhaps the public) for PCNs to ‘succeed’ . Extended access , for instant, is a very challenging prospect this year , alongside with all these arguably QOF-like parameters from impact and investment.
While Covid 19 leaves a long tail of consequences in both primary and secondary care , it is unsurprising that the Health Secretary is blowing the trumpet of vertical integration (VI), i.e. , all GPs to be fully employed by acute trusts eventually. The replacement of CCGs by ICS is clearly a preparatory step towards this ultimate destination.
Older GPs over 50s like myself , have been talking about this VI , in fact , last 10 years .
My advice ,to all younger colleagues, is (1) Protect yourself from drowning in workload , whether so called necessary or unnecessary(2) Do not disregard any ideology to save yourself(and your immediate colleagues) from what appears to be fate-determining option. I still believe ‘one size cannot fit all’. Perhaps there is still room for GPs to call the shots rather than being entirely submissive under any government.
(3) Otherwise, it is never a shame to call it a day throwing the towel , if reality resonates .
Sorry , I always go on longer than necessary
All the best’’
Well done for speaking out about this. Been through the same myself and only just resurfacing six months down the line. Have to add have had fantastic support from practitioner health. Would urge anyone reading this who feels on the verge of burn out to contact practitioner health.
Well written piece by Dr Finnikin – I couldn’t have said it better myself. We want to be there for our patients but we are under a lot of pressure and at the end of they day we are only human as well – no one should work like this. Well done for looking after yourself – we should take care of ourselves – ultimately this will benefit not only us but our patients as well …… how many times have we dealt with patients who have burn out from their work …… yet we don’t follow our own advice because we feel guilty ….. it’s a very true account ….. thank you for sharing this.
Thank you for publishing this honest reflection.I am not yet through my own journey with burn out yet: I’ve recognised it and very much stepped back but (like many others, I believe), I am frightened to take the final step and leave ‘my identity’ and the tribe….but it may well need to come.
Reading honest stories form others is supportive. It removes some of the fear.
On ‘resilience distraction’ I still feel conflicted. I am pleased that real effort is being made by good and caring people both inside and outside our ranks (I’ve been in some of those meetings) – but I am also pessimistic that the real problem is being denied or ignored: that it is not always possible to ‘cope’ with what is expected of us. Ignoring that, and pretending we should/can/must, is storing up some serious harms down the line.
Well done.
‘People, like machines, are subject to breakdown under conditions that exceed their operational capacity’.
(Professor Janice Haaken).
The NHS (in my 40 years experience) was dependent on deeply committed doctors working endless, excessive hours, in extreme conditions, that inevitably exceeded their operational capacity, their dedication, and their seemingly almost inexhaustible resilience.
Thank you Lisa.
Well done! I left finally at 57.5 years. I remember my uncle worked as a GP till 72, but it was a different world and a less abusive system. I am so glad that I left before it killed me, but it has left me damaged.
Thank you Lisa
Vinci – I am really sorry to hear you have been unwell. You are a prolific poster and I respect you greatly
All the best my friend
Sorry to hear it’s got to you Vinci. It does to everyone in the end, unless they just want to be a “yes man/woman” to the government and its running dogs in NHS admin.
Get well wishes to Lisa, Vinci and everyone else who is suffering. Take care 👐