As a GP I make a lot of phone calls. Two recent ones stick in my mind. The first was to someone I had, in fact, already spoken to earlier in the day. They had experienced a case of acute back pain, and while I had confidently dealt with this over the phone, I had sensed that they might have been dissatisfied with the lack of face to face assessment. I decided to call back later that day. They were surprised, and very grateful. They were feeling better, and commented “Thank you for calling back, that is very kind, I really appreciate it” or words to that effect.
I clearly remember making the second call. I had the hospital letters on my computer screen in front of me as I dialed. “Hi, it’s Dr Jonathan here from the surgery. I’ve received the correspondence from the hospital and wanted to check in with you. How are you getting on?” This patient had been diagnosed with cancer following my referral a couple of weeks earlier. We talked through what had happened so far, and what plans were in place for further tests and then treatment. The call ended with me once again being thanked, this time not only for me taking the trouble to call, but also for the speedy referral leading to the diagnosis.
Thank you. I hear it a lot. In fact, most people thank me at the end of the consultation. When a medical student recently spent a 6 week period sat with me, we frequently had patients taking the opportunity to tell him what they thought of me – they were all positive and grateful. And before you start thinking that I am just trying to ‘big myself up’, I really don’t think I am anything special – I think most if not all GPs would get the same response. The phone calls I describe above are just part of our normal, everyday work, and if you are a GP then you will undoubtedly recognize the scenarios.
Being a GP is a wonderful thing. Is it the best job in the world? I think so. It has its problems, and I am not naïve about them, but it is still a job where I believe I can make a positive difference to people’s lives, and that’s what makes it so good.
You don’t, however, currently hear GPs talking positively about their chosen career very often. Last week on two separate occasions I heard people essentially saying that while we as GPs are currently wanting to lobby for there to be more GPs, why would anyone choose this as a career option when “all they hear from us is how awful it is?”
How do we square this circle? We genuinely need there to be more GPs, but how do we balance expressing the challenges currently being faced with all the positive elements of the job that are still there, and why many of us became GPs in the first place.
I became a GP because of the ability to help people ‘from cradle to grave’ , because of the ability to view people holistically, to come alongside people and their families, to work in a broad and diverse setting where you never know what’s coming through the door next, where despite that you can make a difference and where people say ‘thank you’ and really mean it. There were practical considerations as well – obligation to work Out of Hours was disappearing, meaning no nights, evening or weekend working unless I chose to.
All of this remains.
I was at a meeting last week where GP Mike Smith talked about how GPs have ‘lost the joy of the work’. Things have changed over time, the demands have risen, the capacity has not, the work has in many areas shifted onto the GPs, while the resource has not. Despite this, I would argue that General Practice remains a wonderful thing. We just need to re-find that joy. We want and need to be recognised for the work that we do. I recently gave my TEDx talk on ‘Choosing to be a Jack of All Trades’. I will post the video once available, but I talk about the great value I think generalists have, despite the popular opinion that specialists are better (watch my talk to see what I think about that!).
It’s time to start celebrating General Practice again. We need to remind ourselves of the many people we see day in and day out who say ‘thank you’, who value us as people who have helped them and improved their lives for the better. We need to remember the smiles and quips from patients coming to see us, the “How are you, Doc?” the “You’re looking well, Doc” and the “you’ve lost weight, Doc” (yes – patient will say these things). They say these things because they know you. They see you as a part of their community, as a part of their lives that consultant specialists don’t get to be part of usually. This is precious stuff. This is life affirming and the reason many of us are doing the job. We must not let anything drive this out of us.
I think we can have this regardless of our contract or employment status. You can have this whether you are a partner or a salaried GP. It fits nicely with any agenda promoting Accountable Care or Primary Care Home. It is what General Practice is all about, it is our past and it is our future.
We need to find the joy of the job. We need to remember that we are of value. Let’s celebrate and promote all that is good about General Practice. Let’s remember that being a GP is the best job in the world.
Dr Jonathan enjoyed working 8 or 9 sessions per week as a full time GP for many years. He is currently proud to be a 1/2 time GP at Swanlow Practice in Winsford, Cheshire, and works the rest of the week as Chair of NHS Vale Royal Clinical Commissioning Group.
Follow Jonathan on Twitter @DrJonGriffiths