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Thread: I am interested - what do you think of GPs in this country? (long read)

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  1. #1
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    I am interested - what do you think of GPs in this country? (long read)

    Full disclosure - I am a GP trainee.

    Now, this may or may not be a good forum to gauge a bit of actual opinion but I am curious nonetheless. There has been a huge amount of vilification of GPs in the right wing media of late - mostly Daily Mail and Telegraph - the government has been very happy to sit back and let this happen. Now, I haven't actually felt this hate from my patients (apart from the odd person but that has always been the case) by and large my patients seem very happy. So, what are people's actual opinions?

    So, there is a national shortage of GPs at the moment and there has been for some time - the current government promised to increase GP numbers by 20,000 (I think) since that policy started numbers have actually fallen. The demand for appointments has skyrocketed during this time of dwindling numbers. The current media response to this is that GPs are lazy, should be paid less and should work more. I find this astounding. How is it that when there is a lorry driver shortage people can clearly see that the blame doesn't lie with the drivers but with the circumstances and government; however when there is a crisis in GP, the government and chronic underfunding of the health and social care system is not to blame but it is the GPs themselves?

    There is this argument that "well if all the GPs just worked full-time then there would be no shortage", or even "well if we paid the GPs less they would have to work full-time, we pay them too much". It is true a lot of GPs don't work "full-time" except that they do... and then some. It used to be that 9 sessions (each half day of clinical work is 1 session) was full time - so 4.5 days seeing patients and half a day of admin. Lovely. Except that if you did that with the current demands on GP you would work in excess of 80-100 hours a week and only be paid for 40. Now, actually, we can work that much because we have all done it in the past but the actual content of the work is so intense and stressful that honestly I do not think it is physically possible to do it without making yourself very ill very quickly. Perhaps some may think that is a pathetic sob story - fine, but you're wrong - doctors as a whole are pretty resilient people and the levels of burnout, depression and suicide speak for themselves. I reckon nowadays 7 sessions equals about a max for most people and it would still equate to 50+ hours a week.

    There are some that genuinely work part-time i.e. 2-4 sessions a week. For most people that do this, it is because of child care or other commitments (maybe they also have a role in a CCG or at a medical school) - the point is that if you made these people work full-time - they would just leave general practice all together - you'd have less GPs.

    What about paying the GPs less? As a salaried GP you could expect to earn 8-10k per session per year. So if you worked that 7 session 50+ hour a week you'd be on £70k/year at the top end. A good wage for sure. A very low wage when comparing to other developed countries. I just cannot see how that much money is too much for the amount of training (5-6 years med school, 2 years foundation training, 3 years GP training) and the amount of risk and responsibility a GP takes. Partners can earn more - the average partner would take home about 100k/year but they would work way more hours and have to worry about the business side of the practice. Some very lucky partners might earn 150+ but they really are outliers.

    Honestly - if GP is so well paid and so easy why on earth is there a recruitment crisis... it is because the job is extremely difficult and getting harder and many of my medical school friends "couldn't be paid enough" to do this job.

    "But my GP refuses to see me!" - I guess this is where I can only speak from person experience. But some background - there has been a long term push for GPs to offer more virtual contact and this was heightened with covid. We were told to be prioritising remote consults. Now I think the situation mostly works in that if need an appt you will get a phone call first and then the doctor will decide if need a f2f. In my practice that is mostly because pre-covid the waiting was packed and I mean packed at all times - we just can't have a coughing 30 year old sat next to an immunosuppressed 70 year old with breast cancer - there needs to be triage. To be clear - I hate remote consultations - sometimes I feel like I am working in a call centre and it is not what I became a doctor to do, but it is something that, at the moment, we can't get around. Even with all this - if a patient is sick and needs to see me in person - they see me or another doctor in person, the same day, without fail.

    Let me be clear, I do not need anyone to feel sorry for me an my colleagues. We choose to do the work we do. But I do resent the finger being pointed at us when it should be pointed at the government that is underfunding the whole interconnected health and social care system. The anti-GP rhetoric, I believe, is beautifully convenient for the government - when the NHS reaches breaking point (and make no mistake, it will, if nothing changes) what a lovely scapegoat to have - those lazy GPs off playing golf on a Wednesday afternoon.

    So, I don't want anyone's sympathy (or applause for that matter), but I do hope people actually question where the real problems lie and don't just swallow what the media ask them to swallow.
    Last edited by watchstudent; 30th September 2021 at 10:27.

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