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- Page navigation anchor for Give us a reason to be a GPGive us a reason to be a GPIt’s the big elephant in the room. As doctors in training the often ambivalent to downright contemptuous responses from some hospital specialists and colleagues when one expresses an interest in general practice does little to inspire confidence that it is a good career move. Surely this attitude has got to be challenged. Due to negative media portrayals and a lack of understanding of what general practice involves and contributes to patient care, juniors in foundation training and medical students are often left with a list of reasons not to be a GP.Whilst changes are required they will not happen over night and certainly not in time for the next recruitment cycle, but is it not time to start confidently highlighting the many positive aspects of being a GP so they are made more widely known?For instance, as raised by Lyon-Maris et al’s informants, portfolio roles have the potential to make being a GP very attractive. There are countless examples of GPs pursuing such portfolio careers.1-2 Unfortunately, not many colleagues know what a portfolio GP is. They aren’t aware GPs can combine routine clinical work with doing just about anything, be it specialising in a specific clinical area to non-clinical work such as academic research or expedition medicine, to working in the media, to management roles, to working as a medical reservist within the armed forces. The list is limitless w...Show MoreCompeting Interests: None declared.
- Page navigation anchor for RE: GP workloadRE: GP workloadWorkload in general practice can be categorised into several sections, as illustrated by Lyon-Maris et al. Delegation of these sections of work is urgently needed to relieve the pressure on every GP in the NHS. However, in doing so we must be aware of the risks of fragmentation of care. Visits and acute care can be delegated and continuity still retained if there is a common GP record and a named GP retains an overview of the care for each patient.Another section of work is the overwhelming paperwork itself. It is possible to delegate the checking of letters, results, emails, task mails, messages and phone calls by using a doctor’s assistant with experience in working as a nurse or medical receptionist. Almost all of this administrative work can be done by another person, directly working with, overseen by and discussed with the named lead GP for that patient.General practice is in a dire state of funding with the same pot of money being recycled endlessly for additional work, including targets that are not actually directly linked to consultation quality or proactive continuity of care. Practices are having to diversify into areas such as research, education, travel, retail and organisational development bids just to maintain existing income. This further increases workload and takes GPs away from the complex chronic patient care they are most needed for.Delegation of a...Show MoreCompeting Interests: None declared.
- Page navigation anchor for Conflating chronicity of care with complexityConflating chronicity of care with complexityLyon-Maris et al miss the true opportunity of primary care by trying to divide workload into either acute or chronic care, and by conflating complexity with chronicity. Such a view is not new, and has led to resources being misallocated to walk in centres and targets around care planning, rather than effective primary care.The alternative view is that acute and semi-acute care is in fact the complex area, given the level of diagnostic uncertainty, and that the most important ‘care plan’ for someone with a chronic disease is rapid access during exacerbations to a clinician who knows their history.Part of the workload stress for GPs is that while a widening proliferation of organisations are paid to start an episode of care, it often falls on the GPs to ‘end’ such an episode. The most innovative approach, therefore, would be to trust GPs with the resources to manage both acute and urgent care during waking hours, rather than commissioning less efficient and effective alternatives.Competing Interests: None declared.
- Page navigation anchor for RE: GP workload articleRE: GP workload articleI am concerned about the split between acute care and management of chronic illness. I feel this slightly misses the point, in that so one with chronic illness can become acutely unwell, and would benefit from being seen by the same GP. How would this fit with the model discussed?Competing Interests: None declared.