Could you navigate one of the hardest jobs in medicine?
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It’s 3:30pm. Put down that sandwich you’ve been craving since lunch time. In 5 minutes you’re going to meet someone you’ve never met before. Before you meet this person for the first time, I’m going to give you access to a garbled backlog of their details and medical history. Then you have 45 minutes over the course of the next 12 months to keep this person healthy. To identify health problems, prescribe necessary medicines and dish out advice to keep them on track. Oh, and sorry, I forgot to say, I need you to do this for 50-70 people. Every day.
This is the challenge for GPs in the UK and a daily basis.
2018 is a make or break for the general practitioner workforce. Not only are GPs working longer and harder, consultation times are shorter than ever (9-10 minutes)1,2 and many patients are waiting over a week to get an appointment. The spill over from a lack of GP availability is crippling A&Es up and down the country, with January representing the biggest drain on NHS resources in recent memory. Breaking point.
General Practitioners or Paper Pushers?
“I just want to get on with caring for the patients, I am fed up with the endless pointless paper exercises that we are forced to do to maintain our income” 3
And even worse, what used to be a burgeoning career is showing signs of decline. We don’t have enough new GPs coming into the system to match those that are leaving. A 2016 BMC research article showed that 42% of those surveyed intended to leave their career within the next 5 years. Almost 25% wanted to take a career break. Only 6% planned to increase their hours of clinical work.3
Too much workload, too much time spent on doing unimportant tasks and lack of time for patient contact were all cited as reasons to leave. Reduced workload, less admin and longer appointment times were all cited as reasons to stay. 3
In recent studies, over 1/3 were unhappy about the amount of time they got to spend with their patients.3 Nine minutes is not a lot of time when faced with an older patient with multiple or complex comorbidities.
Throw in the negative perceptions of the lay press, ‘Dr Google’ and it’s hard to work out why anyone would want to be a GP in the first place.
“I find the negative image perpetually portrayed by the media and government extremely demotivating fuelling patient expectation and demand which is simply unachievable” 3
And let’s spare a thought for the health of the people looking after our health.
“…the pressure is tremendous. I get home after a 10 h day and feel as if I have been hit round the head with a brick…I am only 40 yet feel burnt out. It is a miserable situation”3
So are we expecting too much of our GPs?
In a word, YES. And while the job description probably hasn’t changed in years, the nature of the environment we all live in now has changed dramatically.
Take a look at the description of the GP on the NHS careers website
“General practitioners (GPs) treat all common medical conditions and refer patients to hospitals and other medical services for urgent and specialist treatment. They focus on the health of the whole person combining physical, psychological and social aspects of care.” 4
That’s a big ask right? But help is coming. Health networks are becoming more connected.
Patients have more tools at their disposal to take control of their own health than ever before. The NHS is even now providing ‘approved’ apps for patients depending on their needs5. Local health services are also evolving as part of the NHS General Practice Development Programme.6
Physiotherapists are become embedded in GP practices in Scotland 7. ‘Social prescribing’ is beginning to give better access to non-medical care in the community. Exercise specialists are running clinics to help patients get back to some level of fitness. Local partnerships and collaborations are improving organisational efficiencies, but patients still need to take charge of their health.
Hippo-crates
So this brings me back to the original challenge I laid out at the start of the article and a famous quote from old Hippocrates. He of the ‘oath’
“It is more important to know what sort of person has a disease than to know what sort of disease a person has”
And all the stats suggest a modern-day GP has less time to get to know the patient. Less time focusing on the ‘whole person’. A gargantuan task in 9-10 minutes every 3 months – if patients even decide to come to their check-ups. And while we all want a GP to ‘fix us’, perhaps their job is more about helping us navigate our way through the healthcare landscape? A master networker.
So while companies and organisations are doing more than ever to make it easier for todays increasingly demanding patients, it begs the question what can we do as the Pharma industry to help our GPs help themselves to help their patients without burning out in the process?
Your next patient will see you now…
References
1. Commonwealth Fund 2015
2. Irving G, et al. BMJ Open 2017;7e017902
3. Dale et al. BMC Family Practice (2015) 16:140
4. https://www.healthcareers.nhs.uk/explore-roles/doctors/roles-doctors/general-practice-gp
6. https://www.england.nhs.uk/gp/gpfv/redesign/gpdp/