Change of perceptions

As promised I am back. Who knows whose reading, but frankly I don't care. It's good to back typing, good to be back to the blogging world. Since I last posted over two months ago, a lot has happened and I've made a startling discovery - GP life can be hard! Shocking, I know, but also true - I've experienced it first hand.

Before you get all cynical on me allow me to explain. When I last blogged in December I stated the reason for the pause in blogging was due to my study commitments, however, during the time off my day-to-day work has been extraordinarily busy. This all came about due to a change in practice. Until October my experience of GP-life was cozy to say the least. I was working in a sleepy rural town filled with the "worried well," patients who had too much time on their hands and would often come with problems that were trivial and often non-existant. It was mainly an exercise in reassurance.

However, since October I've seen the (dark) light. My trainer has been off sick since August last year and as a result it was rightly felt that I should switch practices as my training was suffering. My new practice has been the complete opposite. I've been working at a urban, town centre practice which has been absolutely manic.

In the past I have been critical of GP workloads and how they don't really do that much, but that was based purely on my experiences of working in a quiet GP practice. Now I have seen the other side of the coin. Since October my GP work has been busy to say the least. My morning surgery starts at 9am and the schedules appointments finish at 11.30am. However, extra appointments made on the day ensure that I finish at 12.30pm. I then have at least two home visits and after that have to go through a ream of blood results and hospital letters and I finish the morning surgery by 1.30pm. The afternoon surgery starts at 3pm, scheduled to finish at 5pm, but invariably by the time I leave it is nearer to 6pm.

And it doesn't stop there. A lot of the patients have serious health problems and suffer with a variety of chronic diseases, sometimes more than one which require a lot of help and intervention, so inevitably the appointments run over the allocated 10 minutes. It doesn't help when the majority of the patient population are from the poorer end of the social class, meaning a lot of the time they don't have clue about how ill they really are - "the unworried ill."All in all it has been the complete opposite to my experiences in the quiet rural practice.

On top of all that, the workload has been increased further with my continuing use of the ePortfolio and revision for my nMRCGP exams (the results of which I await at the end of the month). It's amazing to see the range of workloads across different practices and different GPs. In my previous practice the GPs would enjoy a leisurely break at the end of the morning surgery, often go home to have lunch with their families and then return refreshed for the afternoon session. At the new practice, it seems the GPs just about have enough time for lunch. But the significant thing out of all of this is that both types of GPs are paid around the same amount - in fact the GPs in my previous rural practice probably earn more as they also dispense drugs which brings in additional income.

So where has this left me? It's been a complete eye-opener. From being critical of GPs, I now find myself at the opposite end - a GP defender! Having experienced life as a busy GP, I no longer will be joining the GP-bashing brigade. The more important question is what type of GP do I want to be in the future? I find myself in a bit of a confused state. I'm sure most of you will expect me to claim that the rural GP is the life for me, but I'm not sure. This new practice has been busy, but along with that it has actually been interesting. I'm not just dealing with the bog-standard "coughs and colds," but also actual medical problems that require my intervention to improve patients quality of life. I'm managing long-term chronic conditions and seeing progress in a patients life and it seems to be surprisingly motivating. Could it be that I'm beginning to appreciate what it means to be a doctor?!

I'm not sure at the moment where this leaves me. This month I have changed practices once again as the busy practice was a temporary solution whilst we had hopes that my original trainer would be returning. As that is not the case, I have been allocated another trainer in a different practice. This practice is actually spread across four different sites and seems to offer a cross between a rural and an urban type patient population. This sounds ideal to me and will probably help decide where I want to be in the future once I qualify inshallah.

Interestingly, during the first meeting with my new trainer, we had the usual "getting to know each other" meeting. In the past, I've been frank and honest and said that medicine wasn't the most interesting thing in my life and I didn't enjoy my work, but it was something I was good at. Although this time I explained all that once again, I actually suggested that perhaps that perception was changing, following my recent experiences in a busy practice. I'll keep you all posted as this new sense of appreciation develops in the next few months!

Take care all,
Thoughts just flow, when do they have to make sense?