It’s 8am and I’m already sitting in front of my computer at the surgery.
I prescribe myself some coffee and scroll through the blood results and hospital letters that have accumulated since yesterday. There are at least one hundred of them in total.
I get through as many as I can before I see my first patient at 8.30am. I have a minimum of 32 contacts a day – as many as half of these are seen in person, depending on the nature of their issue.
Abdominal pains and earaches are easier to see in person, whereas a contraceptive pill request can often be dealt with over the phone.
Working as a General Practitioner has always been both an art and a science to me. I have my clinical guidelines to advise me what drugs and investigations are suggested for each patient’s presentation.
But people are complex and one has to know how to tailor the science to the personality of the patient. This can take years of practice.
I’ve been saddened by recent negative press articles, complaining about the service that GPs provide. I hugely resent the idea that I am lazy, work-shy and doing my best to wriggle out of seeing patients when, in reality, I’ve never worked harder.
Virtual appointments were essential as the pandemic hit: people who were shielding and potentially infectious were kept away from each other. I saw those I couldn’t manage over the phone in person, but there was always the concern of contracting Covid.
I remember some seriously ill patients who didn’t want to attend hospital. One doctors’ surgery springs to mind where 50% of the patients had that characteristic dry cough that I will always associate with this virus.
Of course, I can understand peoples’ frustrations about remote consultations. As a clinician, I also find them difficult at times and I often work a lot faster and more effectively if I have the person in front of me.
However, it’s not that simple in an ongoing pandemic. Many of the Covid cases I have seen recently have had relatively mild symptoms, reminiscent of a cold. It would be very easy to bring them in to sit in a waiting room with a vulnerable patient (which, clearly, would best be avoided) – so, virtual consultations eliminate the risk of this happening.
I think there has been a public perception that our services have been closed, which has not been my experience
However, some of our patients do welcome virtual consultations. I was talking to a lady today who loves the fact she doesn’t have to drag the kids in with her and entertain them in the waiting room.
We have a lot of university students who enjoy the fact that they can take a call from the gym or the library.
That said, they will never be appropriate for everyone and we need to find a balance and consider the needs of those who don’t have access to a smartphone, for example.
With something as complex as the NHS, it’s unhelpful to scapegoat GPs, blaming them for reorganising their services to provide care in unprecedented times.
I think there is a public perception that our services have been closed, which hasn’t been my experience. Our GP services are something we all require access to throughout the course of our lives and we’re all likely to be patients at some point, therefore all parties must all work together to craft a service that meets the needs of the population it serves.
While, as GPs, we work as hard as we possibly can, there are lots of things that need improvement. Personally, I’d like to see the flexibility of longer appointments for patients who need more time. I’d also like to see more investment in the service to allow greater continuity of care for patients with the same GP.
I struggle daily with a hollow feeling of not having the resources to do my job properly, particularly in the fields of mental health where patients are often told that they are ‘not sick enough’ to qualify for the specialised help that they need.
For a patient who has never spoken about the despair of depression to another human being, 12 minutes is a pitiful amount of time – but that’s generally the length allocated to each person waiting. Sometimes it can take that long to utter a sentence for a patient experiencing profound social anxiety.
I’m often asked if I have ever thought of quitting. Honestly? Long hours and decision fatigue have made the thought cross my mind at times but I don’t think that I could or would walk away.