Before you complain about your GP, this is what you need to know about actually doing the job

I really do understand the frustrations of the general public - I have a family too - but we are working flat out

Emma Nash@DrEmmaNash
Monday 18 April 2016 08:16
Since 2004, evening and weekend GP care has been provided by a variety of NHS, private and not-for-profit providers
Since 2004, evening and weekend GP care has been provided by a variety of NHS, private and not-for-profit providers

I have been a GP for five years, and am well used to seeing headlines bashing my profession. I am also, rather more dishearteningly, familiar with personal tales of dissatisfaction from friends. Regardless of the subject, the theme is recurrent: GPs are not providing a service that the public has been told it should expect.

I rarely respond these days. It's a hard battle to fight alone, with no quick comeback to shed some perspective on the frontline experience of actually doing the job. This time, though, I did.

Exasperated by yet another criticism of not only the waiting time to see a GP, but also the suggestion that the patient might wish to invoice us for the 17 minutes we were running behind, I lost my resolution to not take it personally. The sense of injustice over the negative feeling towards us was overwhelming, so I wrote the post below.

NHS Choices offers self-verified patients the opportunity to rate and comment on any GP practice. Whilst there is a right of reply, of sorts, our duty of confidentiality considerably limits our freedom and honesty. Those who have felt aggrieved by the refusal of an inappropriate sick note, or upset by the GP not prescribing medications which are not indicated, are afforded a public forum to express their dissatisfaction. This is alongside those who have genuinely been let down, and I feel this devalues the legitimate criticism. Publicly aired complaints about our practice include GPs being brought tea, and given that I was out to set things straight, I decided to address this too.

This was not written as a plea for sympathy. I don't ask for, or expect any. What I do seek is to share reality. It is unfair to berate people for their criticism of us when they haven't been given all the information on which to base their judgement.

Furthermore, if people have suggestions on how we can make things work better, then we honestly do want to hear them. Contrary to what some publicity might suggest, the vast majority of us genuinely care for our patients and want to make the service we offer the best that we can.

Here is what I want you to know:

Unhappy with your GP?

Write to your MP.

There is absolutely nothing we can do about this at a practice level.

We cannot recruit any more GPs.

We cannot fund any additional staff.

We cannot work any longer hours and be safe (bet you didn't know that I often leave work around 11pm and have left at 2am before). My 'part time' 5 session (i.e. 20h) is approaching three times that in reality.

Why do you think we're running late? (Genuine question - I'm interested to know what people think we're doing.) It's because people come with lists. It's because 10 minutes isn't enough.

It's because people use appointments that they don't need when actually self-care and time and patience will do the job perfectly well. The human body is designed to cure a lot of things itself, especially infections.

It's because we're interrupted, quite legitimately, by phone calls from palliative care nurses wanting to discuss medication urgently for the dying patient; by ambulance crews called inappropriately who are asking us to take responsibility for patients not being taken to hospital; by the coroner asking us for information to try to prevent a bereaved family having to wait for a postmortem before they can arrange a funeral; by nurses who need us to give a second opinion on something that they're already gallantly managing beyond their duty; by urgent prescriptions that need signing because the patient didn't plan properly (we all make mistakes). I could go on.

We get brought tea because otherwise we wouldn't drink anything for 5h at a time - morning surgery typically is 4.5-5h, with patients every 10 minutes.

Each patient is not just a symptom. They are people with problems, with lives and responsibilities, and we try to treat them holistically. In 10 minutes.

It takes the frail old lady 2 minutes to undress so we can examine her, another minute to get up onto the couch, another couple to put herself back together again. That's half the appointment gone.

We could do longer appointments, but would have fewer.

I really do understand the frustrations of the general public - remember I have a family too, who occasionally need to see a doctor.

But. We are working flat out. There is a reason that there is a shortage of GPs. There is a reason that no one wants to train as a GP.

If we were genuinely working 9-5 on >£100k then why would there be a recruitment problem?

No one wants to do it because it's a draining job, very heavy on workload, and we are demoralised and constantly berated by the press and portrayed as lazy and money grabbing.

If you have ideas on how it could be done better then please share. Genuinely. We are all out.

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