From this month, I will no longer be working as a GP within the NHS. In fact, I will no longer be a practising doctor. I’ve decided, due to the confines of the system, that working in general practice isn’t sustainable for me.
This decision hasn’t come lightly, as I love what general practice stands for and delight in the human interactions I’m privileged to be part of every time I start a consultation. No doubt the pandemic has played a role in my choice. Life slowed down, but life at work sped up. We worked in new unfamiliar ways, which, whilst they may be necessary, have and put up barriers between us and our patients. Aneurin Bevan, political father of the NHS said: ‘Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune the cost of which should be shared by the community’. He was speaking of money of course, and yet it resonates as it’s the idea of general practice supporting the communities to which we belong which I feel is slowly being eroded.
My decision is discombobulating, disorientating and uncomfortable. And yet I know it’s the right thing for me. I think I feel like I’m having an out of body experience because this kind of self-determination has been a long time coming.
The shorter version is that I decided to value myself, to put my needs front and centre and live a life true to myself. The longer version is that, sadly, the current NHS system doesn’t support clinicians to deliver a high standard of compassionate patient-focused care without sacrificing themselves along the way. The workload demands placed on individuals are unsustainable and unreasonable.
What I now realise (with great relief because I believed it for a long time) is that it’s not me who’s broken. The system is broken. There’s huge sadness in my decision because general practice, as a career, is a perfect partnership for my relational, interpersonal strengths.
I absolutely delight in the human interactions I am privileged to be part of every time I start a consultation – so much so that over recent weeks when speaking to patients I’ve thought to myself more than once: ‘You’re an idiot, why have you handed in your notice? You love this!’. The problem is that the emotional human in me struggles. She has not figured out (and in truth, has no interest in learning) how to adapt her work style to be able to connect with people on a more superficial level, which would be necessary to sustainably do all that is expected from her in a day at work.
Add the achiever in me to the way I love to cultivate relationships with patients, and it’s a dangerous combination. I’m driven to work long hours to complete everything that comes my way and invest 100% in every patient interaction (even on the days my bucket feels empty.) So, my work leads me to feel constantly overwhelmed and drained.
I made the decision to change the direction of my life one day, not too many weeks ago, whilst pottering in the greenhouse and listening to Glennon Doyle’s ‘Untamed’ on my headphones. She posed the question: ‘Would I want this for my little girl?’. I wept.
Framed like this, I instantly knew the answer, my work had to change. Truthfully, if my children came home and told me about their work being anything like mine, I would be encouraging them to move on without doubt. I would be telling them that they need to value themselves above everything else. I would be reassuring them that they had done their best in difficult circumstances and that it is honourable to put themselves and their family first. I would be telling them that work should be something we do in our lives, not something that rules our lives.
I realised that by making a decision to step away from my career now, I was showing them how to live bravely, how to value themselves and giving them permission to live their lives courageously. Making this decision is a gift to myself and my children.
I believe the current system is unsustainable and I can only hope for better in the future for my colleagues who continue the good fight. Something needs to change to prevent a mass exodus from the system. Those with power to make change need to act now to protect the most valuable asset the NHS has – its workforce.
I will be working in a new way (specifics in progress – but hopefully alongside and in partnership with general practice), with me at the helm, to support fellow humans through their life. I will be designing my own system; one in which people can flourish, community is valued and wellness (mine and my clients) is at the heart of everything I do. Watch this space. I’m excited.
Dr Lisa Finnikin is a salaried GP in Sutton Coldfield