John Crace 

Who’d be a GP?

Long hours, budget constraints and now outposts in Boots - doctors must be saints, says John Crace.
  
  


It's not everyone who wants to start their day surrounded by invalids spraying germs around their workplace. So the rest of us should be grateful that there are still a few people willing to put in several years at medical school - followed by further specialised training - to become a GP. Who else is going to reassure you that your chesty cough isn't lung cancer? Unless, of course, you do have lung cancer, in which case you're talking to the right person.

But treating people is just for starters. If you just want to indulge in medicine, you become a consultant so that everyone who walks through your door is merely a walking pathology. GPs need to have good communication skills as many of their patients are too embarrassed or ill-informed to explain the precise nature of their problems and it's down to the doctor to decode the verbiage and make the diagnosis.

Even then, your problems have only just begun. You'll find yourself becoming a glorified social worker as the main reason half your patients come to you is because they have failed to access the relevant part of the local healthcare or social service provision. And, if your surgery is a primary healthcare trust, you'll spend the rest of your time wondering how to give your patients the best possible care within the constraints of your budget.

All of which makes the GP's job description rather similar to that of a latterday saint, so it's no real surprise that the government - despite one or two measures to reduce working hours - has found it tougher and tougher to convince medical students of the delights of general practice. And you can't help feeling that Tony Blair's latest initiative to tie in the NHS with the chemist chain, Boots, is not going to make recruitment any easier.

On the surface, the idea of GPs in a high-street chemist ticks all the right boxes; it takes healthcare to the masses, cuts - in theory - waiting lists and gives the impression of something happening. But in reality it reduces the role of the GP to a mere medical functionary and it doesn't provide the level of job satisfaction most doctors are looking for. Believe it or not, most are still motivated by a sense of public service. Not only will they be unhappy about being turned into a production line, they're also unlikely to be pleased about all their prescriptions being effectively privatised at Boots. And if the government forgets this, then the NHS really is screwed.

 

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