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Dispelling Some Of The Myths About General Practice

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I've been a GP for 17 years now and I am constantly surprised by the amount of ignorance there is about what we are and what we do as family doctors.

I'd like to use this blog to dispel some of the myths about general practice and tell you how we fill our days.

The first thing to make clear is that GPs are not NHS employees like hospital doctors. Most GPs are self-employed and run surgeries as small private businesses. We have a contract to provide care to NHS patients but are not NHS employees. GPs employ directly and pay the salaries of their own staff such as receptionists and nurses and either own or rent their own premises. All the costs of running the surgery from staff wages to electric bills are paid for out of practice income.

GPs can and many do offer some private services which are not covered by the NHS contract and which patients have to pay for directly. Examples include: travel vaccination, private sick notes, driving medicals, insurance company reports etc.

Only about two-thirds of our working day is spent doing face-to-face consultations with patients. The rest of the day we are reviewing blood results, writing referral letters, doing home visits, attending meetings, undertaking compulsory educational courses in addition to dealing with the other multitude of tasks associated with running a business.

In the last few years the government has forced us to undergo annual appraisal, which compels, amongst many other things, each of us to undertake a minimum of fifty hours of educational activities per year. Appraisal is viewed by many GPs as of little or no value, but nonetheless eats into the time we have available to see patients.

More recently GPs have been forced to pay for compulsory inspections by the Care and Quality Commission (CQC) Preparing for these inspections is enormously bureaucratic and has yet further eroded into the time we have available to see patients in. The process is viewed by many GPs as a box ticking exercise which does little or nothing to improve patient care.

Everyone and their dog seems to think they know how much GPs earn and has an opinion about it. The reality is most GPs do not earn a 'salary', earnings vary widely as they depend on the profits made by the practice. However much certain factions of the media would like to portray us as overpaid and lazy, the reality is many GPs have seen their take home pay reduce over the past few years. Also, if we were paid vast sums for doing nothing, you would expect medical graduates to be flocking to joint our ranks. The opposite is the case and GP recruitment has been in crisis now for many years.

This brings me on to my final point; waiting times. Britain currently has fewer doctors per 1000 population than almost every other country in Europe. This is due to successive governments' underinvestment in general practice and the health service in general (despite this 90% of all contacts within the NHS occur in general practice and we receive less than 8% of the total NHS budget) Add to this the further drains on our time due to bureaucratic processes highlighted above and you may begin to see why so many people across the country have to wait up to two weeks for a routine GP appointment.

So the next time you feel irked after having waited a fortnight for a rushed consultation with a harassed GP, please don't take it out on them. Pick up a pen and write to your MP, Parliament is the only place the system can begin to change.

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