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Lown et al provide an excellent summary of the broad range of systemic changes negatively impacting UK general practice. But when placed next to these overarching, system-wide problems, the proposed individual level solutions feel unsatisfying. If most GPs and GP practices are indeed already inherently resilient, developing our resilience yet further, while worthwhile for its own sake, is unlikely to ever be enough in the longer term— no matter what personal self-care techniques are utilised. The answers proposed are essentially limited. When confronted with a rising flood of challenges we can all try to become stronger swimmers, but better still to stay dry in the first place. While mobilising the ‘collective resilience’ of our representative bodies sounds promising, it is not clear what this actually involves.
Using a broader definition of resilience may be helpful here. Concepts such as community or disaster resilience are concerned with the 'bouncebackability' of whole organisations, communities or populations facing uncertainty and disturbance. By focusing on individual (psychological) resilience, the authors are obliged to skim over discussion of ‘bigger picture’ factors that may be relevant to general practice. While some are similar to those listed in the article— for example the importance of adaptability and a positive social context— others, such as good governance, good planning/preparedness, and the imp...
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