Reply With QuoteHey all cool here. Unless he was at the practice I used, he is only surmising what happened.Originally Posted by wileeeeeey
Cruel.
Started out with nothing. Still have most of it left.
Hey all cool here. Unless he was at the practice I used, he is only surmising what happened.
Started out with nothing. Still have most of it left.
short version:-
over paid (3rd in the world i believe)
not open enough (its a service industry- needs to be open 8-20, 7/7)
weirdly allowed the best of all worlds of being a monopoly, private business and within the NHS
needs to pay for the cost of running a real out of hours service with real bandwidth
needs to stop off loading it's xs demand and antisocial hours work on A&E
needs to be welcoming (no phone call should start with if you are unwell please call 999)
needs to care about patient outcomes not qofs
most are lovely to chat to but have a real blind spot to their own service provision, some of them are also so far up their own arses it is beyond belief
please don't think this is negative, i have far more manager/exec horror stories then Gp ones
When I look at the salaries of people on this forum I struggle to see how anyone can think GPs are overpaid. As to the issue of people not being able to obtain a telephone consultation, yes it's inconvenient, but I don't know why people think that's because GPs are taking it easy - apparently it can take 3 months to get your watch serviced but everyone accepts that's because there are a finite number of watchmakers.
How do you know the salaries of people here, you probably might know a few at most? I'm sure there are many with salaries a lot lower who are more modest.
Personally, I've always thought that GPs were well paid
I think I would answer each of your points individually in exactly the same way - why do you think that is?
Salaried general practitioners (GPs) earn £58,808 to £88,744 depending on the length of service and experience. GP partners are self-employed and receive a share of profits of the business.
Started out with nothing. Still have most of it left.
this is not including any outside consulting /other work - ive seen consultants /GP's with eye watering total salaries.
do i think GP's ae underpaid? - no , do i think the system they work in needs a major overhaul - yes
the problems within the NHS have been around for a long time and have not been addressed , my practice has gone from not bad to a shambles over the last 18 months.
covid and the recent problems with fuel show that most of the infrastructure of the UK runs on a knife edge , doctors dont vanish overnight anymore than lorry drivers do -this isnt the twilight zone.
Last edited by pugster; 2nd October 2021 at 09:56.
Why bother?
I've seen a 21 year old without a degree in London walk into 40k for a permanent UX role then leave 18 months later for 50k elsewhere.
If I had a time machine I'd go back for a niche/trendy job like that or as a data scientist. The data scientist at our place makes more than the director they report into.
Those figures are not correct.
Too low.
I've just hired a 25 year old in a sales role on a 6 figure package. Fact is many tech/sales/finance guys will make significantly more money than even a Consultant surgeon despite needing nowhere near the same level of qualifications and having nowhere near the same level of responsibilities. So I think GPs (and doctors in general) shouldn't earn less than these people. In the US medical salaries are much higher.
Ryan what on earth...
Where was my phone call??
Then pay your people less.
No doubt it’s the market rate but is the same for GPS, no shortage of trainees.
The bottom end of the scale is.
Perhaps they want to be Doctors, perhaps money isn't their only incentive.
Started out with nothing. Still have most of it left.
Any corrections appreciated.
Started out with nothing. Still have most of it left.
They are roughly correct, like I said in the first post. Salaried GPs earn usually between 8-10k per session (read half day) per year. So it depends on how many sessions you want to do. But you would work my physical time than your allocated sessions because of all the admin that comes with those sessions. Full time would usually equate to 6-7 sessions a week. So between 50-70k per year for most salaried GPs.
Partners can earn more, or less, in fact. Depends how profitable the practice is.
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I've just looked on my surgery's website as salaries have to be published. I'm sure that the last time I looked they were listed individually i.e. Dr X earnt £YY. However, now it's given as an average and here's the text cut and pasted from the website (with surgery name removed):
'The average pay for GPs working in XXXX Doctors Practice in the last financial year was £108,166 before tax and national insurance. This is for 1 full time GP, 6 part time GPs and 1 locum GPs (who worked in the practice for more than six months).'
If you take out the high and low figures that will, very approximately, cancel each other out, you have 6 part-time GPs earning £108k each. I'm not getting into whether that's too little, too much; it is what it is. What I'm pointing out are actual figures from a fairly typical GP surgery.
Last edited by Skier; 2nd October 2021 at 18:59.
I know. I am an ST6 and CCT in August.
The BMA website is open for anyone who wants to check what we earn.
Salaried GPs have no official pay scale. It is up to local negotiation between the doctor and the employing practice, hence my comment about the figures being incorrect.
FWIW anyone who thinks the pay for doctors is excessive should consider the terms:
Ridiculously long degree course accruing huge student debt
Poor starting pay
Appalling working hours and T&Cs (would you want to work long days, weekends and nights in a hugely stressful job, moving work location and specialist area every 4, 6 or 12 months during the near decade of postgraduate training. I had a 126 mile daily commute for a year with zero choice in the matter)
Constantly being asked to operate at the margins of your competence and/or skill level
Having the full gamut of emotions and the human experience thrust in your face every shift whether you like it or not that day
Personally, I find the job hugely rewarding because the non financial aspects such as having a cup of tea with the old boy on the geriatrics ward, or passing by a patient whom you have treated in the street who stops to thank you for literally saving their life is something you will encounter in no other profession.
Prior to training as a doctor I worked briefly as a teacher and then for years as a civil servant. Both those sectors play crucial roles, but I can tell everyone that there are senior professionals in both of those getting paid more than most doctors, for a lot less disruption to their personal and family lives (last time I looked, teachers and civil servants were not on rotas working nights covering the day jobs of tens of their colleagues).
The idea that any of us is creaming off the state and enjoying a life of leisure is complete and utter hokum.
<<Appalling working hours and T&Cs (would you want to work long days, weekends and nights in a hugely stressful job, moving work location and specialist area every 4, 6 or 12 months during the near decade of postgraduate training. I had a 126 mile daily commute for a year with zero choice in the matter)
Constantly being asked to operate at the margins of your competence and/or skill level
>>
John, I had those conditions all 37 years of my time as a Civil Engineer, and the pay was much less.
Last edited by chrisb; 2nd October 2021 at 19:43.
Not to some of the Parker Knoll critics on here.
When you look long into an abyss, the abyss looks long into you.........
Sure, so that is obviously a surgery that is profitable and has a lot of partners. It also depends what they call “part-time” because they might count anything below 9 sessions as full time but in actual fact the hours involved in 6 or 7 sessions is what most people would call full time.
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And this is where the world is all wrong. And you sound smug as """" about it.
And how much of your working day was spent carrying the direct responsibility for the lives of each and every client you interacted with?
The answer to that is why doctors get paid more.
Pretty much the same for me. Single doctor and one (friendly!) receptionist. Doctor worked 5 days mornings and evenings, including saturdays, did home visits, and went to a London teaching hospital every Friday ( I believe he was a Brain Specialist).
Now there appears to be at least 6 doctors and maybe 4-6 receptionists/secretaries, and its nearly impossible to get an appointment (on the phone...)
Also it seems that Doctors use the internet too, generally giving printouts of what they find that they think would be useful. Something which the majority of patients could do themselves.
Probably only 6 figures starting with a 1.
Of course we use the internet! Just like before the internet doctors would look in books… I still do that occasionally. Do you think it is humanly possible to learn everything about the human body and disease?
We give printouts of reliable information. And yes patients could do that themselves. The difference is I know how to interpret information available on the internet. The internet is great, if you know how to use it.
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doctors appointments i can get same day, now dentist appointments not been able to get one of them for routine cleaning for two years now !! oh and i think they get paid appropriately for " your life in their hands"
A well written and emotive post.
My cousin is a GP. It’s taken her years of training to be called lazy and over paid.
Unfortunately, the system will always be underfunded. Conservative, Labour, Brexit, European. It’s doesn’t matter. Our countries finances have always been a house of cards and if you put into the NHS what they actually need, it’ll come tumbling down.
As an employer, if I treated my team as the trusts treat theirs, I’d be (quite rightly) hauled over the coals.
What’s the answer? Who knows!
What do I think of GPs? Highly variable. We have one at our local surgery, well no one can understand how he's still there, why he bothers or why he doesn't go and find something he might enjoy.
Twelve months ago I had an ear problem, a bad one. He told me even if he had to refer me to hospital I would be waiting at least 6 months. Five appointments with 3 GPs later (in about a 5 week period) I finally saw a new locum. She said "leave it with me". By the time I got home the phone was ringing, "can you get to the hospital in the next hour?" Sorted.
So, what was all that "6 months" stuff about, any idea?
Thing is this seems to be the experience of most people.
The practice I use has 14 GPs listed on their website and 14k patients registered. Before lockdown I could see a doctor next day at the latest, and book an appointment online if I didn't mind waiting a few days. . Now I'm lucky to get a phone back in the next 10 days.
On their website they have a 'Reception' page, where you can click on 'Make an Appointment'. This is where that takes you, note which is the last option they give you....
Started out with nothing. Still have most of it left.
Re-posted from another thread:
My GP practice's procedure for getting an appointment. Here's how it works:
They only allocate appointments on the day - no forward appointments are allowed.
You have to ring between 08:30 and 09:00am to try to get an appointment for that day. This will be a phone call-back appointment... all Face-to-Face appointments must be preceded by a phone call with the doctor who will decide if you can have a F2F appointment.
If you are the 16th or greater queued caller, you get told to ring back later and cut off.
If you happen to be caller 15 you will have to wait a long time. In fact, if all appointments are allocated for that day and you are still in the queue, you will just get cut off. I was cut off at 09:15 a few days ago.
If you ring up during the day to explain that you were cut off before getting an appointment - tough. You cannot book a forward appointment for a subsequent day and are told to ring back tomorrow morning between 08:30 and 09:00am. Rinse and repeat.
I understand that this procedure may unique to my GP practice, but it is an example of the barriers to entry now widespread in the Health Service. There must be some people who give up and thus present (finally) at the Doctors/A&E with more serious conditions.
It strikes that there are two questions being argued here:
What do you think of General Practitioners in general and what do you think of the service provided at your practice.
I think most GPs are hard-working, well-intentioned folk who are appropriately paid (subjective) for a challenging and highly-skilled job.
My local practice is very good and I’ve been very impressed by the service provided. I recognise that provision of primary care services will vary by area. The volume of work, care expectations, as the complexities of healthcare have risen enormously in recent years. I would cut most GPS some slack.
I can't fault my local GP Surgery here in SW London. There are 8 or 9 GP's and I can usually phone up after 8am for an appointment that day - can't remember a time when I have not been able to get an appointment. You do have to now go through the telephone triage bit but I'm fine with that. During the hot spell earlier in the year I rang to request an inhaler for hayfever related asthma. Spoke to a GP and he was happy to prescribe without a F2F after seeing my history and asking a few questions..
Last year just before Covid struck I needed to see a nurse to get some stitches removed - receptionist said all the Nurse's are booked but you can see a GP and they will remove them for you - on the same day I rang.
I have two sisters who live in Plymouth though and it seems they do have trouble in seeing a GP when they need to.
All the various GP's I have seen over the years (been at the same practice for 25 years), have been very professional, helpful and sympathetic for both minor ailments and after a serious injury.
My nephew is a young Dr and I know how hard he has had to study over all the years in Med School in Birmingham and now in a Bristol hospital, equally so for his girlfriend who is training to be a GP..
Obviously peoples experiences and wait times to see a GP vastly differ around the land, just wanted to post my experience to offer some balance.
keep up the good work OP and I hope you can treat yourself to a nice watch :)
Almost impossible to get an appointment at mine or my Mother’s surgery (who I unfortunately have to deal with). My record is being number 47 in the queue and after finally getting through will say - no appointments today, ring back in the morning.
Even something straightforward like a telephone medication review will probably be November (or can’t book next month so ring back in November).
No idea who my allocated GP is, never see the same locum twice. All rather different to TVs Behind Closed Doors where the doctors seem to know all their patients and even get up out of their chairs to see patients in/out, no chance of that at ours.
That’s how the practice I use used to be.
Started out with nothing. Still have most of it left.
Interesting topic and many differing opinions.
I've been qualified for over 25 years now and thankfully left the NHS 15 years ago because I was heading for burnout. 5 days a week, 10 hour days, often 11, with NO BREAK and relentless work (as a GP). Moving overseas gave me a new lease of life and far better working conditions - I began to enjoy it again. Sadly, the health service here is heading the same way as the NHS. Chronic underfunding, dwindling GP numbers with a forecast 50% planning to retire within the next 10 years, an increasingly aged population with increasing patient demand and complexity of consultations, and a massive rise in "paperwork". Compulsory 24/7 cover means that we are expected to provide weekend cover too and find it hard to take time off because we have fewer colleagues to provide satisfactory cover.
I love consulting.....but I will be gone at the very first opportunity. One "mistake" or "error of judgement" could lead to me losing my career, and those mistakes are always more likely when fatigue is present.
I'm not paid badly but I work bloody hard for it and I try to do my very best each and every day. But, I've had more than enough now.
The NHS and General Practice is slowly dying - we live longer, we are complex beings, healthcare costs money (a great deal of it) - and patients are the ones who will see the effects of this. The expectation that appointments should be available 0800 - 2000hrs every day of the week is absolutely unrealistic. There are never going to be enough appointments to satisfy demand, particularly when everyone wants to be treated "yesterday". Create 100 extra beds in a hospital and those beds will be filled....constantly. GPs simply cannot keep up with the demands placed upon them and I fully expect numbers in the UK to decline.
Anyway, enough of all that.
A new working week tomorrow - with all appointment slots filled already.....and the phones aren't open until 0830 tomorrow!!!!!
Last edited by DrDunc; 3rd October 2021 at 11:20.
Where do you work now?
Unfortunately I cannot see myself making a career out of GP - after I CCT I might locum a little and do some OOH work as I prefer the more acute stuff but with the way things are going I think I am plotting a way out while I am still relatively young. It's a shame.
When I started in construction, 360 men a year died whilst at work, as a direct consequence of that work, part of my job was to prevent 80 tonne machines interacting with 12 stone men. Every action on a construction has the capacity to kill or maim.
I don't think that many GPs have the expection that talking to a patient may kill them.
I'm a GP as well, but sadly not for much longer. I'm done, burnt out, fearful that the stress will kill me before I retire, tired of the abuse and a government who have systematically run the service down while blaming us for all the system's failures.
About 15 years ago my wife could see what was happening to me and the system and advised me to find myself a way out. I paid for training to become a special interest GP and so was able to reduce my general practice input while pursuing a career interest that I really enjoy. My working days look very different. My days as a GP are usually 10-11 hours long, without any breaks, and I don't have any time in my day not dealing with patients, so my admin and paperwork are done when I get home. Each day of general practice generates about 4 hours of admin, so 2 days as a GP means a whole extra day of work in my own time. Effectively a two day a week job is 28 hours per week.
Compare that to my alternate career. I do two days a week, start at 9, finish at 4.30. I see 22 patients in booked face to face appointments. There is no admin, no extra work apart from regular governance meetings.
And the remuneration? About the same.
I have been offered the opportunity to work full time in my second career. It's a no-brainer really. Yes, it will impact my pension contributions, but ultimately I have to live long enough to enjoy the pension.
To answer those of you who want to see your GP face to face. I'm happy to provide that for you. However, with an increase in population, the bulge in the over 60s, the increasing demand and consulting rate of patients, the decreasing numbers of GPs, I will only be able to see 1/3 of you. The rest will get no medical care at all.
At least, with the current, albeit broken, service, we are prioritising and trying to manage expectations. You aren't getting face to face appointments because they are a limited resource in this day and age and we can't afford to waste them. Hence, we do need to know why you want to see a doctor before booking as there may be more expedient ways to manage your case. For instance, we may arrange tests before you see someone, or direct you to a more appropriate professional straight away.
68 days left. I know, because I've counted them.
Sounds like a good call to me. I just hate that this is such a common story. GP has the potential to be such a wonderful job but they way we are forced to do it means many hate it, which means patient care is poorer and new doctors don't want to be a GP, it is a proper crisis in the making.
What is your second career if you don't mind me asking?! Always looking at what other opportunities there might be out there!
I have no axe to grind with GPs, I volunteer for the NHS and my wife is one of those dreadful management people in a major hospital, that everyone thinks gets paid for doing nothing and the docs could do a better job.
So 12 weeks ago I got hit in the eye whilst riding a motorcycle on duty. Lost sight in my right eye by the time I got home. Rang GP, receptionist conversation, go to your optician as the GP won't see you for sight issues. Ok, so I rang every optician in town to try and get an appointment, nobody had any emergency appointments available on the day and won't forward book as they have to see you within x hours our they get in trouble apparently. Eventually I found one that would see me. Went in and got referred to the Eye clinic as an emergency trauma. From then on, I have had fantastic care, been seen by a consultant every week for the last 12 weeks, they also found an growth in my eye, so the trauma was sorted and the growth has now been sorted as well, although I will not get full sight back in my right eye.
So after every visit I get a letter from the hospital which is also sent to my GP. Every letter asks the GP to prescribe x drugs and manage, blah blah. So in 12 weeks, I haven't heard a peep from my GP and the Eye clinic has taken on the task of all prescriptions so all good. So I haven't really suffered due to the GP or surgery lack of contact and I guess I could have chased them, but I kind of assumed it was unto them to contact me or at least acknowledge the correspondence from the Hospital.
But probably like a lot of others, I have not needed the GP and am healthy, the only other contact was two years ago at the start of Covid, when I caught it, even then I only had one phone consultation with the GP and I just got on with it.
So my expectations of the GP service is pretty low. One last point about working hours, if you think you are working hard for your 70k, you should try working in a commercial company for that salary, I did, and with commuting and meetings, that never seemed to happen during the working day, my day started at 5am and finished around 21:00 and included weekends.
The answer from the GP receptionist always seems to be - Go to A&E, which just puts more pressure down the line.
ST3 GP trainee here
Totally not a sustainable career choice. Unfortunately I'm in a single income household and am short by £1500 a month just to stand still. No extravagant purchasing or anything. We are only a family of three
London living is expensive and GP trainee pay, and tbf GP pay, cannot cover London living on a single income. So what to do?
Moonlight in aesthetics like many colleagues? Sell IV vitamin infusions? Do out of hours work and ruin my life and body? Do private GP? Do DWP assessments? Leave and do something else?
Fact is, I really enjoy the work but it doesn't pay. The responsibility is enormous and the pay is not in line with the responsibility. So why be a martyr?
It's a real shame.
Silly system, wouldn't you agree?
The eye doctor should prescribe the drops you need. If they send a request through to the GP about this, it'll first go to some admin staff who will then pass it on to the doctor. Doctor already busy with other stuff. Why not just prescribe the drops and include details of the drops on the letter so that GP is aware and there is a record of what happened.
If the reason behind the eye doctor wanting GP to prescribe is budgetary, then clearly budgets need to be redesigned to avoid these situations
That is a ridiculous over-simplification.
Every single doctor-patient interaction carries risk for the doctor. Patients generally come to see us because they have concerns, and if we miss a clinical sign, misinterpret a symptom or prescribe ANY medication at all, we run the risk of harming the patient.
GPs will have 20-30 odd patient encounters per day. That is a huge amount of risk to carry and your example I am afraid is not of the same order of magnitude.
I wish it was 20-30, that is what I do as a trainee, my seniors often do more than double that.
Agreed though, it is the "directness" of the risk. Decisions correlate directly with outcomes and responsibility is all on the doctor. Whereas, for example, a politician may make a decision that kills 1000s but because there is not a direct route of responsibility they will often not have any repercussions.
Fair enough, I should have said 20-30 per surgery.
I think the general public generally have no idea of how hard our training is, and the nature of the ongoing stress of being a doctor. You can pick up threads from this discussion about GPs chatting to patients in their comfy offices hiding behind reception staff manning the phones, but what about earlier in your career, when you were carrying the crash bleep in a busy hospital and had to prioritise which of the sickest patients you were going to see first, or the time as a paediatrics SHO in your first week when the gynae registrar hands you a blue and hypoxic newborn from a Caesarian, or the time when a patient you are called to see turns pale in front of you and arches their back as they are having a massive MI right in front of your eyes. This wasn’t even a daily occurrence in some jobs. It occurred multiple times in one of those 12.5 hour shifts where you stayed a couple of hours late despite not having eaten, drunk or passed urine in the shift, just to ensure your patient was ok so you could make it back home and sleep in the knowledge they were going to be alright.
Of course, back in the comfortable zone of ignorance, you could think that your role in commercial sales or ensuring site health and safety compliance is comparable. It is not, and it never will be.
Are you going to pay back your education grant then?
Agree, it wasn't just eye drops, steroids, folic acid, two anti biotics, associated pills to stop the steroids messing up the gut I guess. At the start, 40 tablets a day, 16 eye drops - then no bloody sleep because 60mg steroids keep you awake. So then had diazepam. Then trot off to Pharmacy, who didn't have all the drugs all the times. Anyway, all good now, but your right, bonkers system.
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