GP's are not lazy - we're working harder than ever
Dr Lizzie Croton is a GP based between Birmingham and Highland Scotland. She’s also a sessional doctor with NHS Practitioner Health.
A Day in the life of a GP
It was widely reported that GP surgeries were closed throughout the pandemic – this could not be further from the truth. GP teams continued to work and were in fact busier than ever. Dr Lizzie Croton gives us a snapshot into her day.
It’s 8am and I’m already sat 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 in total. I get through as many as I can before morning surgery starts at 08.30. I have a minimum of 32 patient contacts a day of which a third to a half are seen in person depending on the nature of their issue. Abdominal pains and earaches are easier to see in person, while a pill request can often be dealt with over the phone. A typical day may take me from migraine headaches and a sofa allergy to a new diagnosis of cancer.
Working as a General Practitioner has always been both an art and a science to me, and at the moment it’s tougher than ever before – for both the patients struggling to adapt to a new way of interacting with their doctor; and for clinicians dealing with the backlogs caused by COVID.
I’ve been saddened by a deluge of negative press articles recently 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. Like most GPs, I regularly pull 11 or 12 hour days. I find that the problems that my patients bring to me are taking far longer than the allocated 12 minutes to address. It takes energy to listen closely to what a patient is saying so that they feel heard. It takes skill to meld the clinical guidelines we have to the personality of the patient to come up with a management plan that makes sense. It’s also incredibly rewarding and I’d be hard-pressed to find something else I’d rather do, but helping others can take an emotional toll.
I can understand peoples’ frustrations about remote consultations. As a clinician, I also find them difficult at times. I can 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. It would be very easy to bring them in to sit in a waiting room with a vulnerable patient (and we can’t have that). Some of our patients welcome virtual consults. 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. They will never be appropriate for everyone and we need a balance.
With something as complex as the NHS, it’s unhelpful to scapegoat professions such as GPs, blaming them for reorganising their services to provide care in unprecedented times. We are all likely to be patients at some point and going forward I would like to see all parties working together to craft a service that meets the needs of the population it serves. In recent months, the Doctors’ Association UK has met with patient charity HealthWatch, to gain an understand the difficulties patients face accessing GP services. They’ve called for an investigation into the problem from NHS England - which I think this is a positive step.
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. Sometimes it can take that long to utter a sentence.
I’m often asked if I have ever thought of quitting? Well, it has crossed my mind at times but I don’t think that I would walk away. I believe fiercely in what the NHS stands for. I think it is incredible that we can access free healthcare at the point of delivery. My current trainee, who qualified overseas, is gobsmacked at what the NHS provides. We must protect this.
Global crises like the COVID19 pandemic force change and in that confusion and uncertainty there is a space to consider what we want the next step to be. Let’s work together to achieve this.
Dr Lizzie Croton is a GP based between Birmingham and Highland Scotland. She’s also a sessional doctor with NHS Practitioner Health. She has an interest in mental health and the management of chronic pain and “as yet” medically unexplained symptoms. She’s held various roles as a GP, writer and member of the DAUK’s GP committee.