Name: Dr Joanne Reeve
Title: GP, National Institute for Health Research (NIHR) clinician scientist and chair of the Society for Academic Primary Care (SAPC)
I have been an academic GP for 11 years. I finished my PhD in 2006, and then had a couple of different jobs.
Four years ago, I was awarded an NIHR Clinician Scientist fellowship to develop and test ideas about finding generalist solutions to complex health problems.
I now work for one day a week as part of a clinical team in a busy inner city practice. For the rest of the week, I am university-based but work with researchers, educators, clinicians and patients as we critically examine if, when and why generalist care matters.
With so much change going on, it feels like my ‘lessons learned’ change on a daily basis. But sitting down to write this, five things came to mind.
Academic work has made me a better generalist, and so a better GP
Indeed it was academic experience that brought me back into clinical practice. When I qualified as a GP in 2001, I was frustrated that the clinical medicine I had learnt was too often distant from the problems that patients brought to me. I headed off down a different path (public health), and on the way got a chance to do a Masters degree. I came across ideas that helped me see how I could do things differently.
I started to learn how I could work ‘beyond a protocol’: to produce an individually tailored account of what was wrong with a patient and what we could do about it. These ideas underpin the work I now lead within the School for Advancing Generalist Expertise (SAGE). I believe that the core academic skills of scholarship are integral to the professional training of all generalists.
As a practising GP I can make a difference for one patient at a time, but as an academic GP I can help change the care many patients receive
Both roles are important but we need more GPs using extended skills in education and research to lead and innovate, and to act as the bridge between clinical and academic worlds. It is frustrating for everyone if the evidence produced doesn’t match the needs of front-line practice. We need more GP input into shaping what research is done – not necessarily doing the research, but certainly offering strategic leadership in developing and interpreting the ideas.
Every day, a GP works with patients to make sense of the problems they are experiencing and find a way to deal with problems. My academic role is not dissimilar, in a way: I help to translate the problems of daily practice into questions that others – researchers and educators – can help us to answer.
Academic practice was nothing like the stories I had heard of ‘ivory towers’, disconnected from patient care.
Rather I discovered a world of curious and creative people, critically exploring different approaches to understanding health and health care. I found an opportunity to be part of change, making a difference.
However, I also found that the straight-ish career path of clinical practice was replaced with a winding road. It took me a while to work out that short-term employment contracts were the norm and not a sign of complete incompetence.
For me, a mentor has been a crucial part of dealing with the uncertainty of academic practice: someone who can walk with you when things get sticky, and celebrate with you when they go well. So if you’re thinking about trying some academic practice, the best thing you can do is talk with people who are doing it. You’ll find some helpful starting points on the SAPC website (sapc.ac.uk).
There are growing opportunities for GPs to get involved in these roles – for example, working with your local Primary Care Research Network, your CCG research and development group, or academic department. You could also have a look at the Sowerby Innovation Fellowships or NIHR In-Practice Fellowships.
The SAPC is working with the RCGP to develop more opportunities for GPs to be involved in all these roles: whether it’s professional scholarship, leadership roles in advancing practice, or academic practice. We will be posting more details on the SAPC and RCGP websites in the coming months. In the meantime, if you have questions I’d be delighted to hear from you. My email address is Joanne.firstname.lastname@example.org.