When I first became a GP, there was a problem with easing octogenarians out of the practices they had served for more than half a century. Then came Mrs Thatcher’s purchaser-provider split and a new GP contract. Suddenly grey-haired GPs became an endangered species and no-one wanted to go into general practice. Now in 2007 there are not enough openings to go round for newly trained GPs, and their older colleagues seem to be finding more options for the last years of their working lives.
NASGP’s membership includes doctors of all ages. There are will-be partners, have-been partners, may-be partners and wont-be partners. I fall into the second category, and like many colleagues have found that flexibility as a sessional or freelance GP has returned to me control over my work and my life, and restored my enjoyment in seeing patients. It has been a great six years.
Now I am about to give up. “NO!” said a friend who has already done so, “We are not giving up, we are stopping.” We doctors have a strong tendency to do guilt, and if you were lucky enough to secure a place to train as a mature student, as I was, you have even more to beat yourself up over. But we should not apologise when we recognise that it is time to move on.
GPs are used to change. After all, each working day we start again every ten minutes. And we are constantly learning to keep up with new drugs, techniques, new ways of doing things. Change keeps you flexible, keeps you young. Until it wears you out. It’s not what you do; that changes slowly. It’s not patients who change. Their problems and worries have as much to do with the human condition – unchanging – as with disease, and even disease doesn’t change that much. It’s not what you do, it’s how you do it that changes. At the moment it seems to change monthly. DESs and LISs are commissioned and we struggle to remember what codes we are to use, then they are decommissioned and that doesn’t count any more. Every time there is a reorganisation some doctors, usually those towards the end of their careers, will call it a day. Been there, done that twenty years ago and it didn’t work then. When you have got to the stage in life where one new fact inserted into the brain pushes one old fact out, you quickly feel overloaded. When I give up — sorry, stop — I look forward to getting my brain back. I think of all that space which will be available for all the things that over the years have been stuffed into the cramped corners of my cerebrum.
Will I miss it? Yes, of course. The multitude of human contacts, the fascination of the glimpse into other people’s lives, the intellectual stimulation are addictive. But there are other things to do and new pleasures to be found.
I’m not giving up. I’m stopping. And starting again.
First published in NASGP Newsletter 'The Sessional GP' October/November 2007
Judith Harvey was a research scientist, ran the VSO programme in Papua New Guinea and taught in a Liverpool comprehensive school before going to medical school. She has been a partner, a salaried GP and a locum and an LMC chair. She started a charity which for nine years enabled medical students to go to Cuba for their electives.
Judith is a long-time supporter of NASGP and has been providing regular articles for The Sessional GP for over 12 years, her reflections ranging widely on practical, ethical and cultural aspects of health and medicine.
Judith has now published all her articles from the NASGP website as a new book Perspectives: A GP reflects on medical practice and, well, just about everything…