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My last five patients have all led with a tirade on how hard it was to get an appointment with me, thus wasting a good two minutes out of their precious ten. I’m desperately trying to move them on, ‘Gosh yes, that’s awful, now what can I do for you today?’, but it’s hard to get them off topic.
They have a point, though. Have you tried to get a GP appointment yourself recently? I had a go, with my own GP. I spent hours listening to an engaged tone, and when I got through, I swear I could hear muffled laughter when I asked for a routine appointment the following week. And neither could I have one after that because they only book so far in advance.
So I’m not surprised that patient frustration with getting appointments is increasing. Nor am I surprised that we’ve had the first fall in GPs relative to the population since the 1960s. I’m just surprised anyone’s left.
Rocketing demand against a trickle, at best, of new funding, has rendered the job unrecognisable. We didn’t sign up for this. Exactly half of my journal club is retiring the second they hit 55, and the other half of us would if we could afford to. If it weren’t for a bunch of unpaid mortgages and poor financial choices, I think the NHS would have collapsed by now.
Meanwhile, those of us still clinging on come up with ever more inventive ways of managing the unmanageable. Refusing to see anyone who is even a moment late, running a never-ending ‘on-the-day’ emergency list, even trying to limit consultations to just the one problem. All the old tricks. And all we do is heighten the stress for everyone, not least for the staff, in trying to maintain the fortress. Do we want receptionists or bouncers?
We are all being let down. No-one in general practice is occupying the role they want, or the role they once thought they might be able to occupy. Not the patients or the doctors.
Even the most forgiving of patients is likely to be annoyed the moment they step through the door, their threshold for complaining as lowered as their blood pressure is raised. They come to consultations with a list of everything that has happened in the last month and might happen in the next one, because they sure aren’t going to get a slot in between.
And for us, it seems more and more that we exclusively see the complicated chronically ill, the poly-pharmacied and multiply-co-morbiditied, one after another, every 10 minutes, and are haunted by the feeling that we can’t do anything like our best for any one of them.
We haven’t ended up in this position by accident. It’s because warning after warning to government has been ignored. And if we lose many more GPs, we might as well lose them all, because the working conditions will leave those remaining with intolerable stress. And where will we find a GP to treat us when we get it?
Beatrice Duck is a GP. She writes under a pseudonym
Society resembles that distant uncle, and tried and true way of thinking resembles his tirade. With the exception of for this situation, rather than blocking it out, we give riveted consideration to each word, and afterward we settle on significant vocation choices dependent on what he says. Sort of a strange thing for us to do. ref: https://laustan.com/
I recognise your description all too well, as so many will.
Very, very sad.
I used to be passionate about being a GP, now I'm wondering how long I can hold it together before I have to leave due to the intolerable stress we are all under.
I’m amazed at all the improving access initiatives designed to burn out all the existing GPs even quicker. I do find it strange about Jeremy Hunts mantra about the 5000 extra GPs . Was it based on faulty information or was he just well - lying
I have read many pieces like this over our 10 year decline. It’s a great piece. However, the service will not collapse. This is a fantasy. Wishful thinking, even. It brings to mind politicians and managers being flayed for their failures and having to come crawling back to us, begging to be saved. A comforting image when one is overworked. More likely the service will continue to drearily deteriorate. Only we will realise by how much. If you are becoming burned out [ if you are reading the BTL comments after pieces like this, then odds-on you are. Either that or you’re a recently retired gloater] then the only decision to make is how much you are willing to take.
I agree. I think that GP-dom is in crisis. I feel that this needs to be acknowledged, first and foremost by the government who keep making the vague suggestion that it will eventually get better, that we should be patient.
One thing we could do if a crisis was acknowledged would be to stop doing QOF. I love the pop-ups but they should be more for the individual patient, to help us keep up with exactly where they are with their conditions. Not a threat that we won't be paid unless we fill in A-F on all the templates. We need to concentrate our energies on seeing the patients, not adding more coding.
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