'Me? I'm Just a GP...'

Being a GP isn't about glamour. It's not about high tech equipment. It's not about cutting edge research, or shouting "Get me some paracetamol, stat!". There is very little drama. It's about the challenge of dealing with everything in a tiny amount of time. Of having the skills to develop an instant rapport with a patient you may have never met before...

I went to a school reunion a few years ago. When the conversation inevitably turned to work, and what everyone was doing now, mine was without doubt, the least exciting job. "You're a doctor? What sort?" After the tenth time, I wanted to lie and say I was a foetal surgeon, operating on tiny babies before birth, at the forefront of technology and medical glamour, or an innovative researcher, close to curing cancer. Maybe a brain surgeon, or an intensive care consultant?

I found myself saying "I'm just a GP", then slinking off to a corner. There aren't enough GPs. Young graduating doctors are not going into GP training. With the current state of the NHS, there's a lot of negative media about the future of general practice, and junior doctors feel it is an insecure speciality. They don't know what it will be in five or ten years time. They just know the press hate us, the politicians nod then ignore us, and it's putting them off.

Being a GP isn't about glamour. It's not about high tech equipment. It's not about cutting edge research, or shouting "Get me some paracetamol, stat!". There is very little drama. It's about the challenge of dealing with everything in a tiny amount of time. Of having the skills to develop an instant rapport with a patient you may have never met before. It's about everyday people living everyday lives, and the problems that worry them. If you think you are above treating piles, indigestion, thrush, eczema - this is not the job for you. If you can appreciate that however un-glamorous these conditions and their treatment are, if a patient is suffering from them and it makes their daily lives miserable, then maybe it is. I'm a GP and I can fix those problems. I can solve it for them. And while it's not sexy, headline-grabbing medicine, it makes a difference to my patients. So here's an example of the patients that make my day; that I make a difference to. Usually in small ways but ways that are important to them, and help me remember why I do this job.

The 70-year-old I treated for a urine infection - such a simple thing to resolve. The next week she brings me a slice of cake, saved from a friend's birthday party, because she had felt well enough to go and gave me far more credit than I deserve.

The mum who cries with relief when I tell her she's doing nothing wrong with her new baby. That babies don't sleep through the night, that she won't ruin him with cuddles, and that she's doing brilliantly with her eight-week-old.

The veteran who came last week with his son, and felt I was approachable enough to return this week, admitting he has constant nightmares and flashbacks from his service, but has never told anyone.

The middle aged lady with menopausal symptoms. Her friends talk about the hot flushes, but no one else complains it hurts to have sex. She's worried she's not normal. We talk through what treatments there are to help.

The embarrassed 17-year-old with acne - I tell him I can treat it and that he doesn't need to put up with it anymore; I know it will make a huge difference.

The man convinced he has cancer - when I tell him it's a simple fatty lump, he looks ready to cry.

The four-year-old who has been told "be good, or the doctor will give you an injection". I spend 15 minutes convincing her I won't. She runs back to give me a hug at the end of her appointment.

The nursing home visit to the lady with a twinkle in her eye. "I get bored with all these old people sat looking at me" she tells me, winking. She 98.

The 14-year-old couple who come wanting contraception. We talk through all the options; the risks and benefits. They both understand the decision they are making, and I encourage them to come back any time if they have more questions.

The elderly lady who comes with a simple rash. When I ask her if there's anyone who can help apply to cream to her back, she cries. She talks about her husband. He died two years ago, and she feels like she should have "got over it by now". She feels awkward bringing him up to family and friends, that they have all moved on and she cannot. I tell her she will never truly get over this. I have nothing else to offer so simply listen.

The man who hobbles in after standing on a broken glass the night before. He's too scared of hospitals to go to minor injuries or A&E, although he knows that's where he should be. As I gently remove the glass with forceps, wincing all the time, he thanks me profusely for not making him go. My attempt at a dressing is laughable but he is thrilled.

The abscess that bursts as I examine it - instant relief for the patient. Weirdly satisfying for me.

The relative who gives me a book of poetry at the end of another home visit, because they think I will appreciate the sentiments inside.

The thank you card from the patient addicted to prescription drugs. When we first met, I refused to prescribe anymore and made him agree to a gradual reduction. I thought he would never come back. He has never said thank you, but felt able to write it and tell me now he feels human again.

The committed teacher, struggling with crippling depression who refuses to take time off for fear of letting her students down. It's one of the few occasions I pull the "I am your doctor and I am telling you, you need some time off" card. It's paternalistic and I hate doing it, but sometimes it's warranted. A month later she is massively improved and back at work, enthusiastic as ever.

The man with high blood pressure, who accepts the 4 new medications I have to try to bring his readings under control. I give him side effects with every single one and after two months we are back where we started. As I feel guilty, he says "Don't worry Doc, you tried your best. What else can you do?" I could hug him.

The 19-year-old with constipation, mortified at having to come in. I tell her it's my favourite thing to treat, because it is so easy to fix. She looks relieved as I talk her through the options.

The homeless patient who I have fought endlessly for help for, but who is constantly discharged as he can never make an appointment - the card he brings me means more than almost anything else I have ever received from a patient. I know what it took for him to think about this, go and buy it, find a pen, write his and my name, and bring it into me.

All the patients in my surgery which is running 45 minutes late, who don't grumble and tell me it's ok, they understand things are busy. There is nothing more stressful for me, but there are some patients I cannot rush. I will not cut off the grieving parents who lost a baby to keep to time. I cannot make the ambulance come any faster for the man with chest pain. I have no control over how long it takes the hospital to answer the phone, then bleep the doctor I need to speak to for advice. I don't refuse to see the patient our practice nurse is worried about. I do the best I can.

These are the little things that make my day. That are apart from all the politics, the headlines, the negativity. Ten-minute too-brief glimpses into people's lives where I try to make a little difference. Next time they hear about how dreadful GPs are, I hope they remember our appointment today, and think of me a little more kindly. Maybe it is a glamorous job after all. When you add up all the appointments, I've potentially made a difference to almost 40 patients today. Not many other people can say that.


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