I am an ordinary jobbing GP in a non-training practice focused on delivering a good service to my patients. I find the current appraisal system irksome rather than helpful and so I turned to the article in the February 2008 issue1 with interest.
I am glad that someone is looking critically at the system but the background of the authors concerns me. Three out of the four authors are employed by or have close ties to the organisation involved in devising and implementing the system. I am sure that they are honourable people, but I think it may be difficult to be objective about a system to which you have devoted much time, energy, and emotion. The study was funded by the bureaucracy that stands to benefit by keeping it going. We rightly criticise drug companies for that sort of thing. Would we ask an architect to investigate why his radical new building collapsed? I would have preferred an independent research body such as the Kings Fund or similar.
The authors comment towards the end that the value of the process declines with repetition but that those GPs who found the first appraisal valuable continued to do so.
I would certainly support the first point. Large parts of my preparation for this year were simply cut and pasted from last year. As to the second point, perhaps the process should be voluntary and only for those who find it valuable? The percentages in Table 1 measuring the utility of appraisal against a broad range of descriptors show a poor rate of return for all the effort.
The only form of appraisal worth anything to me or my patients is to be measured against a clear set of accepted and evidence based criteria. Until they can be agreed and properly tested, leave me alone with my professional responsibility.
- © British Journal of General Practice, 2008.
