Category: Opinion

Might a headlong rush to implement ICSs erode the trust that those who have to work in and implement ICSs have for those who drive this agenda? When there is such fragility and strain across an entire service, a natural pause in proceedings at this point may over the longer term, create lasting success.

The effect of being stopped and searched by the police can be psychologically traumatic and leave one feeling scared, powerless and humiliated. I thought about my patients. A lot of patients I look after are black and I wondered about how negative interactions with police could affect their psychological health and wellbeing.

“Look sorry, right, no offence but we need a white doctor.” Dad looked at the wall as he spoke. It was almost as if something was compelling him. I really didn’t know what to say. I felt myself flushing, the prickle in the back of your head when you feel you have done something wrong. What now?

Health experts and politicians have warned for over 170 years that health inequality is killing those in the most deprived parts of society. We now witness the poorest in society disproportionately dying of COVID-19, suggesting that the social murder observed by Engels in 1845 is still going on.

The new GP contract in England now recognises the necessity for clinical pharmacists to ensure the optimal use of medicines for patients within all primary care networks. What about the benefits to the wider healthcare team within general practice?

Everyone of us in the health service has overheard unacceptable rudeness, sly put-downs, exclusion or smiling say-the-opposite-of what-you-mean British insincerity. We need to acknowledge that it is happening. There is no mysterious genetic or melanin fault causing excess deaths among health workers of colour.

How much does it take for us to genuinely express sorrow and compassion for the terrible trials our patients endure? We have pride in the NHS but we have prejudice too. Perhaps it is the NHS clinician that is Icarus, flying too close to the sun of belief that we deliver optimal treatment for our patients and ignoring the unmet needs that drive them into the private sector.

An individual working as a GP runs the risk of becoming an automaton. Evidence-based medicine and professional standardisation contribute to uniformity and by definition a reduction in diversity. Camus says that “if the world were clear, art would not exist” and I would suggest that if health was straightforward there would be no primary care.

Some reflections on retirement… Ours is a great community. I look back with thanks, but forward with both compassion for the world and belief in our ability to be better than this. And in a deeper parallel, just as we as individuals consider our era, our transitions and re-birth, so must a profession consider its own, prompted by time or the times, to move on.

Decision fatigue is something we have all experienced. We each have a finite amount of mental energy that we can expend on decision making before our brain starts to look for a shortcut. Decision fatigue is also a well recognised reason behind poor clinical decision making, decision avoidance and as a precursor to burnout.

As a 20-something millennial GP trainee, the sudden talk about the future of primary care is exciting. I once heard a futurologist say, “Don’t ask ‘what will it look like down line?’ ask ‘what do you want it to look like?’” I may not yet be in a position to orchestrate significant service redesign, but I can tell you what I would like my work place and career to look like.