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From the newly qualified GP

As general practice modernises, it can feel that we are losing a body of committed, faithful GPs – that the volunteerism and vocation of previous generations is being lost. People hark back to the likes of John Sassall and recall GPs who lived their lives for their patients. This idea of a single physician serving a local community, on call 24 hours a day and tending to patients from birth to old age is enticing. But did this type of doctor ever exist? Was this ever a healthy way to practice medicine? Clare Gerada has spoken about these venerable doctors and the possible damage done to current and future generations in idolising such imagined practice. The notion of a single doctor serving a community, 24 hours a day is incompatible with normal modern life. However, I focus on remaining resilient and plotting a career trajectory that suits my family life, I also treasure some of those traditional features of general practice. Continuity is still a major feature of general practice. I work in my main practice only 2 days a week and yet, according to my recent patient satisfaction survey, over a third of those asked view me as their ‘regular’ doctor. This certainly fits with my day-to-day experience: Patients who are prepared to wait a few more days to see a particular doctor are able to, if they wish. I have worked in this practice long enough to glean some of the soap opera of life. I see babies grow into small children, teenagers turn into parents and older people move from one condition to another. I am starting to piece together the jigsaw that makes up our local community. There are families with rare conditions, some with a tendency to somatise, others with a weakness for addiction. I am learning who is married to whom and who used to be married to someone else. This element of ‘continuity’ is a fascinating counterpoint to the more mundane business of diagnosis and treatment. I also live near the practice, leading to some interesting situations. I once chatted with a lady in Marks & Spencer for some time as we recognised each other but couldn’t think from where – our conversation faltered when we both realised that I had performed her smear a week earlier. I treasure seeing patients out of context. It’s a relief to see that someone’s cold was simply that, not sepsis. It’s intriguing to catch a glimpse of a person’s life beyond the consulting room. As with Hemingway’s iceberg theory, my brief encounters take on a deeper significance when I can see more of people’s lives. I might notice a well-presented woman in a shop one day and meet her caring for an elderly relative the next. It’s refreshing and humbling to be reminded that my interactions with people make up but a small part of their life experience. Finally, I believe vocation in general practice will never die. We do not do a glamorous job. We could be better paid elsewhere. It is, however, a vital job. It is indispensable to the NHS and crucial to the communities we serve. GPs will always demonstrate compassion towards the patient sitting in front of them. We train for a decade to gain a grounding in medical knowledge and then temper it with humility and understanding. This will be true whether we are working 6 days a week from a one-handed practice in the Scottish Isles or locuming with an urban out-of-hours provider. So, while I’m no Dr Finlay, there is still a magic to the work I do. There is continuity, a firm grounding in the community and compassion for the individuals I serve. I am fortunate to be a GP in today’s world.