GP shortage – what can you do about it?

Please note that I am employed by HYMS in facilitating medical student placements, any thoughts expressed are personal and not officially approved by HYMS.

It’s all the Governments fault…

It is no doubt that General Practice is struggling at present, a mixture of poor manning, lack of funding and then a barrage from the media despite our best efforts is more than enough to try and destroy primary care.

But yet, we still work and there doesn’t seem to be a solution anytime soon.

It is clear that there is a shortage of General Practitioners, and it is estimated to be around 8000 short. As with any problem, it is easy to ‘blame’ someone else, in this case, perpetual MPs who seem more content to privatise the NHS rather than help it.

Zone of control

I am a huge fan of ‘You are not a Frog’ and they will often talk about shapes of power. One element of this is about control and what you can do in this situation. The numbers and tasks seem so monumentally huge and overwhelming that it is easier, and mentally safer, to say ‘this is not my problem’. This though, oversimplifies the problem and reduces the fact that we can in-fact do something. It is worth though taking a moment to identify what we can control and what we can’t control.

What I can’t control…

I would love to magic up 8000 doctors. I can’t, I have very little influence over Government policy or medical student numbers, how many drop out. Etc etc. If thinking about the task in this fashion will no doubt, make you depressed and that is not the aim of this post.

What I can control…

To unpack this, cast your mind back to ‘why you are a GP’?

It is worth thinking about casting your mind back to how you got into your job now, or what inspired you to get your current job? When did you change your mind?

I always wanted to be an Orthopaedic Surgeon. I was keen on it during Medical School, really enjoyed the whole process, any opportunity that I had to adjust my own time to dedicate to this area.

This was the case until I was a Foundation Year 2 (FY2). I managed to do the job and had started to do my surgical exams. I realised that even though I enjoyed it, I didn’t ‘love it’. The job was fine, and I learnt a lot, but realised that to get anywhere I needed to be passionate about it.  I clearly wasn’t passionate, and so forcing myself down this path was likely to be damaging. This, in combination with failing miserably my initial surgical exams, gave me the answer. The other problem, or solution really, is that I LOVED my GP placement in FY2.

I remember joking with my supervisor that I loved the GP placement, and it was all his fault. It was a centre of Birmingham practice which had 5 practices that had amalgamated together (Hall Green Health) and was a busy practice with a wide range of issues and struggles as you would expect. Despite having only four months there, I was hooked, I had a handful of patients that I had seen multiple times and the idea of having your own ‘patients’ was brilliant. The knowledge as well of the other GPs and their holistic thinking made me really warm to the speciality.

So what can we do?

From my own experience, I wouldn’t have done this without my FY2 experience. So that then begs the question of where else do have contact with Primary Care? Namely multiple points throughout medical school and then potentially as a FY2.

It is clear then that we can ‘influence’ medical students directly by showing them the benefits of primary care and really thinking about their student experience. We are then, in some part, in competition with other specialities for doctors. Depending on the medical school we may have differing amount of student contact, if at all?

I cannot expect that every practice will be able to accommodate medical students, FY2s, registrars… for many reasons, space, lack of training, impact to output. This though, is only the surface of where students have contact with primary care. The teaching within University has call for GPs to help and then it is within these contacts that you can help out. Teaching isn’t for everyone though, and that is fine, so what else can be done?

Social media has a part to play in terms of looking at what message is being put out. It is easy to put out negative posts and there is no doubt that work is tough now and stressful – but does it help? Is it representative of what is happening? Have you put anything positive out? My point being that it is easy to be negative and we are prone to be ‘negative focused’ but does that paint the bigger picture? I mean if it is ‘that bad’ then why are you still working there?

I appreciate though that this is a spectrum and I know of doctors who unfortunately been unable to continue with working and this post is not meant to belittle their own health. I have had to change my own job due to my own health and so not here to impart guilt.

Conclusion….

Yes, there is a shortage, the process for replacement is going to be a long one. A lot of the problems are very much not within our control, but resist the temptation to ignore this problem and think what can I do?

Impacting the student and registrar experience is the obvious answer, but below are a list of questions that may help.  

1)    Does your practice take students? Could you?

2)    Are you making the most of your students there? Are they involved?

3)    If you can’t take students in practice, could you help out at the University (if local!)?

4)    Do you train registrars?

a.     If so, are they getting the best experience?

b.     Would they want to work with you?

5)    Can you help your local registrars, teaching on VTS schemes?

6)    What picture of General Practice do you promote? Is positive or negative? Is that a fair representation?

7)    What got you into General Practice? What support would have benefitted you?

 References:

BMA Pressures: https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/pressures-in-general-practice-data-analysis

Guardian Letter: https://www.theguardian.com/society/2015/sep/23/general-practice-is-facing-a-perfect-storm