“Oh, you’re a GP? When are you going to start seeing patients?”

Kasun Theivendran is a GP working in Birmingham.

The vitriol that has been directed towards General Practitioners over the last few months has felt relentless, destructive and confusing.

Encountering inaccurate, misleading, or even laughably fictitious statements about the profession has unfortunately long been part of being a GP. Whether we’re defending the profession as a junior doctor on a hospital ward round, or contesting the notion that we deal with “just coughs and colds” to an unaware individual, confronting untruths about our work is nothing new.

In addition, shouldering misdirected frustration and being unjustly stereotyped is also incumbent with being a GP. The reason a patient may have experienced difficulty in booking an appointment involves many factors. However, often a thoughtless and simplistic conclusion is drawn; it’s the GP’s fault. A hospital doctor may have had an unsatisfactory experience with a particular GP, for which there are several perspectives to consider. Nevertheless, it is not uncommon for the initial response to be superficial and unsophisticated; all GPs are to blame. Therefore, in order to survive as a GP, having an impervious and determined temperament is essential.

Yet, the recent depiction of GPs by a subsection of the media seems to have taken its toll on the profession, and broken the spirits of many. The pandemic caused distress, disruption and chaos to all sectors of society. The already strained primary care service became inundated with unprecedented demand, and had to rapidly adapt in order to continue to provide care for its patients. This introduced a significant change; face-to-face consultations were no longer the default for appointments. GPs swiftly acclimated to a mixed model of consultation styles, including telephone, video and face-to-face.

My own experience of this, and listening to patients’ opinions, has been overwhelmingly positive, and is a feeling that is echoed by my colleagues. Patients no longer have to inconvenience themselves by booking time off work, or sourcing care for their children in order to make the journey to the practice to speak to a doctor. We have discovered that a significant proportion of consultations can be safely and effectively managed virtually. If after speaking to the GP, via a telephone or video call the issue needs a physical review or assessment, a face-to-face consultation is booked. This decision is made jointly, between the patient and the doctor, taking into consideration the patient’s symptoms, circumstances and technological availability. Furthermore, junior doctors hoping to qualify as GPs are trained to make this determination, through various assessments and examinations, which have been modernised to reflect the changes induced by the pandemic.

Inflammatory headlines and articles attract a wider audience, compared to a well-reasoned and considered viewpoint. They exploit the natural human tendency to react emotionally rather than rationally. It is easier to assign blame to a group of people, rather than understand the imperfections in the system. This is a lazy journalist tactic, but an effective one. It sells, and diverts people’s frustration from the system, to a selfless, hardworking and exhausted group of people. The change in the way GPs now consult is substantial, and as with any transformation, there will be continued development. However, this change is not unique to general practice. When a GP refers a patient to secondary care, it is likely that their first outpatient appointment will be a virtual one, either by telephone or video.

The portrayal of the relationship between GPs and the public we serve, by a proportion of the media, is simply untrue and unrepresentative of real patients. At a recent social event, I was questioned as to whether GPs are seeing patients. I was baffled. We are seeing patients, and have been throughout the pandemic. I responded by enquiring about this person’s experience with her own GP. It transpired that she had not been in contact with her GP at all, but was simply reciting what was printed in the newspaper. This is the danger.

Irresponsible journalism conceived from recklessness and inconsideration, creates a false narrative with the public, which will produce disastrous long-term consequences. What are the implications to the patient-doctor relationship in primary care? How will this affect workforce retention? Will this deter junior doctors from considering a career in general practice? What are the consequences on the morale of GP trainees? Do we need to introduce a “how to deal with unfair blame” module into the GP curriculum? Should we use this as an opportunity to address the unhealthy relationship that sometimes exists between primary and secondary care?

I don’t know the answers to this endless list of questions. However, I do know that the days of an overflowing GP surgery waiting room, crammed with patients sitting shoulder to shoulder, becoming increasingly disgruntled that the GP is running late, are well and truly over, and should never return.

 

Featured image by Photo boards at Unsplash