All posts by Michelle Sinclair

Empty Promises & Disenfranchised Doctors

Resilient GP strongly condemns the actions of DoH and their bulldozing of the negotiations of the junior doctors’ contract.

The Government made an election promise to find 5000 new GPs. The first move has been to cut the pay of doctors training to be GPs by up to an estimated 31%. The imposition of an unfair contract will ultimately result in the loss of the best and brightest that are already paid less than comparable peers in other industries. It will become unaffordable to be a doctor in England.

This move will ultimately harm patient safety. Prompt and decisive action is needed by the Government to rectify this travesty.

“It’s not our fault, those nasty GPs made us do it!”

“Morning, how are you? So you’re struggling with your knee? Ok, let’s take a look, pop up on the couch.

Right, what I suggest for the time being is some anti-inflammatories and gentle exercise. It’s better to avoid those drill wielding hospital doctors for as long as possible. It’s a bit of a slippery slope once you embark on the surgical route. Let’s see if time and patience will do the trick.

Hello again, no better? Physiotherapy for you then I think. They can work wonders.

Still no better? Righto, let’s get an X-ray sorted and we’ll get you off to the orthopaedic guys, to see if they can help. There are a number of possibilities and treatment options depending on X-ray and scan results, let’s see what they say.”

So, this is option one. This is what goes on in every GP surgery, every week of the year, but let’s take a look at the parallel universe of the British Orthopaedic Association.

“Morning, how are you? So you’re struggling with your knee? Ok, let’s get an MRI and ask the orthopaedic surgeons to see you.

REALLY??? Are you serious?

General Practice and Practitioners are becoming inured to the constant barrage of abuse and approbation from politicians and the media, but there is a particularly offensive sting to ill-considered criticism from colleagues, who frankly should know better than to throw stones in their secondary care glasshouses.

The phrase, “…….if GPs are doing their job properly….” has a wonderfully arrogant and patronising ring to it don’t you think? And as for, “………performance of this investigation (MRI) replaces the traditional medical skills of history taking and physical examination of the patient…”, well frankly, words fail me.

General Practice effectively manages the vast proportion of clinical presentations without the need to refer to secondary care. Those that are referred are done because further management is beyond the clinical expertise of the referrer, hence transition to the supposed ‘specialist’.

But it appears not. Orthopaedic surgeons are apparently incapable of utilising “the traditional medical skills of history taking and physical examination of the patient”. Nor are they able to deal effectively with patient expectation. No, instead it appears it’s the GPs fault for not managing the patients properly in the first place.

If we listen carefully outside the orthopaedic clinics, we will hear the bleating cries of the poor little lambs, “we didn’t want to do an arthroscopy, those nasty GPs made us do it.”

Key Message, What Great Value General Practice Is

Here’s a reflection.

Today, my wife and I locked ourselves out of the house. Silly mistake; we left the key in the wrong side of the door, and it shut behind us.

So, following a rather poorly conceived attempt to fish the key out the lock with a bit of stout wire, I called a locksmith.

He turned up three quarters of an hour later, put a gadget through the letter box, and opened the door. It took him about three seconds, and he charged us £60. I thought that was fair enough.

I left the house and went to do a home visit of my own; a rewarding one, which involved some chronic disease management, a bit of social care, and an incidental check on a spouse.

The care I give that patient – and which I am delighted to give, and which I enjoy giving – encompassed eleven visits since Christmas, alongside correspondence, test results, working with consultants and district nurse colleagues, meeting with a social worker and also involved two other GPs here, our admin team and our nurse.

Her care for an entire year from our practice costs the NHS about twice what the locksmith charged me.

Primary care is a good deal for the NHS, and a good deal for the patients we look after. This election, look past the empty soundbites, and the policitcal grandstanding, and ask yourself whether you feel that it’s going to be in good hands come May.

Dr James Booth

I Am Your GP

I don’t want much, I am your GP.
I want enough appointments, I am your GP.
I want longer appointments, I am your GP.
I want to feel that I can focus on the patient in front of me, without dreading the crushing workload waiting when they leave, I am your GP.
I want to smile and look up expectantly when someone knocks/calls/stops me in reception to ask me something, I am your GP.
I want to concentrate on personalised family medicine, I am your GP.
I want to see you when you are unwell with medical needs that I can help, I am your GP.
I want to feel optimistic on my way to work, knowing today my referrals will be read, my patients cared for in hospital and their concerns listened to in outpatients, I am your GP.
I am your GP, I cannot replace your sister, father or mother for sensible advice.
I am your GP, I have no legal qualifications.
I am your GP, I have nothing to do with housing, immigration or your ability to get into the school of your choice.
I am your GP, I know nothing of ‘mould’ in your bedroom, or heating or double glazing.
I am your GP, I have no idea how to manage your bullying boss, demanding mother in law and uncaring partner.
I am your GP but I cannot provide all medical services alone, unsupported, at the beck and call of patients, relatives, nurses, reception staff, carers, consultants or nurse specialists.
I am your GP and I am expected to respond to all and do all that is asked – even if I have no appropriate training, funding or experience. And if I refuse, I am made to feel that I am failing my patient.
I am your GP and know that pharmacists know more about medicines, physios know more about musculoskeletal pain, and psychologists know more about managing your dysfunctional thoughts. I also know seeing other professionals will inevitably cost you money.
I am your GP and seeing me is free.
To my patients, their relatives, local professionals and colleagues in both the community and hospital environment….. If you are asking ‘the GP’ to do something, have you really considered whether it is essential, or is there an alternative? If things do not change have you considered you are driving us to extinction? Have you considered life without GPs? I think you will wish someone told you sooner….

Petra House