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Whole person general practice

Dr Stephen Opare-Sakyi is a Portfolio GP and RCGP Humber and Riding Faculty Diversity Lead & Hon. Secretary

I am a whole person general practitioner (GP). What do I mean? I am a patient that requires health care; I am a clinician to my patient, a husband to my wife, father to two children, brother to two sisters, a friend to my friends; lost my dad last year and I am also dealing with the pressures of life just as everybody else is doing.

My job expects me to provide whole-person medicine to my patient at any point in time.1 I am expected not to complain but get on with my job regardless of the government’s extra demands on me and abuse from frustrated patients and the press. The suicide rate for GP is four times the national average.2

The current demand for GPs is unrelenting. The pandemic led general practice to move to ‘total triage’ to reduce the spread of covid 19, i.e., to protect our staff and patients.

The suicide rate for GP is four times the national average

This was a challenging task. I felt the relationship with some of my elderly patients worsened, as most of them struggled to access digital healthcare, such as booking appointments online and accessing video consultations.

 

The table below shows some of the typical day’s work during the current covid 19 pandemic.

face to face Consultation telephone Consultation prescriptions
reviewing results reviewing patient and hospital letters Staff, medical and other training supervision
Triaging e-consultation flu and covid jabs Practice meeting
Processing referrals Home visits medication reviews
childhood immunisations managing national and local targets coroner reports
handling complaints Working on my appraisal and revalidation Managing end of life patients.

 

With very short notice, UK general practices were asked to deliver the vaccine programme in addition to our various other roles. We are still providing the vaccine programme for the NHS despite issues with workforce retention.3 I am asked to work harder with fewer resources and expected to be resilient during these challenging times.

I notice these pressures and demands taking a toll on me and my declining mental health. As a whole person GP, my relationship with my family deteriorated, not spending time with my children, not enough time to see friends, losing interest in my job, feeling burnout, etc… I felt my support mechanism is beginning to fade away.

NHS England, the media and patients need to acknowledge the extra pressures they exert and be mindful that ‘whole person’ GPs are at the forefront of primary care.

To sustain and retain the dwindling workforce, the government, NHS England, the media and patients need to acknowledge the extra pressures they exert and be mindful that ‘whole person’ GPs are at the forefront of primary care. We need to be strong enough to deal with such demands. If we break down, who will be around to advocate for and take care of patients because we are already as we are already in short supply.

To continue to provide a whole person’s medicine to my patients, the entire system needs to change. Changes need to occur within the practice, locally and nationally. Implementing appropriate resources for our patients by encouraging QI projects within practices, workload which will not hinder patient care, and sufficient funding from the UK government so that my colleagues and I can thrive (not just survive).

References
1. RCGP Curriculum (2021) Being a general practitioner (accessed 9th December 2021)
2. Gerada, C (2018) Doctors and Suicide British Journal of General Practice 68 (669): 168-169  (accessed 9th December 2021)
3. Owen, K Hopkins, T Shortland, T Dale, J (2019) GP retention in the UK: a worsening crisis. Findings from a cross-sectional survey BMJ Open; 9: e026048. doi: 10.1136/bmjopen-2018-026048 (accessed 9th December)

Featured image  by Kylo on Unsplash

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