I agree about the need for flexible training and career development to get flexibility at work through life. It's better to get people into the right job, balancing their careers with other aspects of their lives, both professionally and personally, than have them dissatisfied, underperforming, or leaving.1,2
A different way of working means to be motivated, not stressed, but also to use and learn from each other's life experiences.
Involvement in teaching and in management, or simply reducing time involvement as a doctor, will raise the standards of care. So we need protected non-contact time within the working week to stimulate clearly defined roles, responsibilities, and terms of service.
Teaching, research, and management have to be relevant career options, whose status and conditions should receive strong consideration and payment in workforce planning and skill utilisation. These are important factors against burn-out and frustration, mainly visible in GPs more involved in these activities, and also to fulfil the new definition of general practice and GPs as clearly and definitely edited by WONCA, after drafting work by the EURACT Council.3,4
It is really strange that some health ministries in some European countries, as the one I am working in now, are still not applying the European directives on flexibility in the workplace. This is concerning a flexible career option, as well as reduced normal clinical time when involved in teaching, research, and management.
Roger Jones5 wrote about seeing a much bolder attempt to endorse the ‘mixed portfolio’ approach to general practice in which patient care is combined with other non-clinical activities.
I also think that it should be introduced as a ‘wedge-shaped’ commitment with substantial work in early years, tapering to a considerably reduced ‘working’ commitment given to more senior doctors.6 This would be a chance to reinvent general practice as an attractive career with a progressive career structure.
Flexibility has to suit different stages of life to allow someone not to work absurdly when your forces or your mind are ‘conflicting’ and, at the same time, permitting doctors with particular options, not to leave the profession for a long while yet. And, as a health system, ‘use’ their forces and experience.
- © British Journal of General Practice, 2008.