GPs need a new narrative

It just so happened that both BMA News and Professional Engineering flopped through my letterbox this morning.  One is full of ideas, people, technology, solving problems (Drax Power on the cover, cutting its carbon emissions by 86% with biomass, “they said it couldn’t be done”).  The other, I think you know, crisis, resignations, strikes.  Everything they want begins and ends with “The government should…”.  A Tweeter during last week’s LMC conference called it “learned helplessness”.

For such a fine profession to see itself so dependent on others I find a great shame.  I’ve been to both BMA/RCGP at Tavistock/Euston Squares and living just a stone’s throw apart illustrates how their output is barely distinguishable these days.  They give me a nice cup of tea, I go away and nothing happens.

The BMA has an urgent prescription for general practice.  The aspirations and values are fine, the survey responses predictable, but the solutions are all about government funding, structures, premises, encouraging self care (how long have they pointlessly banged that drum?), what other people can do for general practice.  It won’t work.

The evidence about what general practice can do for itself is compelling and transformational.  We’ve been saying it for five years.  Demand-led thinking does work and keeps working.  They’ve ignored it, touching only the edge when they refer to telephone triage for urgent cases, or that 86% of GPs agree with triage being effective.  By the way, failure to consider the whole system makes this an added danger to workload.

Just one story where the practice is happy, doing everything same day, with better continuity and growing the business blows the prescription apart.  I dare you to be unmoved by this, and there are lots more. Is the uncomfortable truth that it doesn’t suit the BMA/RCGP narrative?

You’re advocating self care.  Look in the mirror.

This week we had over 80 GPs at the webinar “Unlearning the appointment system” (recording now on the link).  Asked what they saw as the drivers for change, overwhelmingly they said improved service for patients.  Saving GP time was a poor second, increasing income came nowhere.   There is a thirst to know how to change, yet so many current beliefs are in the way.

Our next webinar addresses another orthodoxy:

Patient choice:  Mirage, deception and the surprising reality.

Register for Thursday 18th Feb, 8pm

Register for Friday 19th Feb, 1pm

Best regards,

Dr Sara Cowell


PS Coverage in GP Online this week.  Even BMA News slipped up last May when a positive letter from a GP won Prize Comment.

PPS You heard about Jeremy Hunt’s rash advice this week, Google your child’s rash.  Here’s a real one from yesterday, a GP told me.  The mother completed an askmyGP for her baby, which invites her to attach a photo of the rash, and sent it in.  GP sees it, phones and advises mother no need to bring in.  Personal, remote and highly efficient general practice.

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