Sherlock has been back on an NHS old time General Practice Returners Scheme for almost three months. And already I am in special measures, and a target for abuse, from the rest of the doctors in the practice. My back is against the wall. So far this expedition has cost me thousands of pounds and months of my life, so much for their being a national shortage of GPs. Regardless of what I have written below, money and time are not my deepest reasons for returning.
My experience of returning to NHS general practice is not pleasant. Far from being welcomed back in the fold, I have had more obstacles placed in my way than on an army assault course. General practice is closed club and they do not want new members, least of all old members applying to rejoin. Those they want reflect those who they would like to be, young, bright and blonde supported by those who will not say boo to a goose. Unfortunately, being a dog, I am different from other trainees. I am slightly old to be a dog, having reached the grand age of 58 and three quarters years, and I am also old to be trying to get back into NHS general practice.
When I left general practice in 2011, the pay had dropped to £35 a hour and work was difficult to find. Another reason for leaving was the strict limits placed on target-driven consultation times. 10 minutes no more or less for each consultation. I had an attitude problem, that no problem I could solve in 10 minutes was worth my attention. I left when there were plenty of doctors in general practice because many medical graduates found general practice to be a haven from the developing chaos within the hospital service.
Over the last 5 years, it feels as though a crumbling system has desecrated and all but destroyed, in the manner of a religious monument captured by extremists in Syria or Iraq. Although General Practice claims to be patient centred there is no longer any evidence of that illusion. Not least, there is now, apparently, a shortage of doctors has become acute.
The GMC medical cull and the complexity of revalidation, the European working time directive, the trend towards part-time working and the generous pension arrangements available to doctors in their 50s and 60s have meant there are fewer doctors available on the shop floor. (Sherlock, being a dog, does not have a pension and is therefore not able to retire gracefully). Principles (the SME business owners) of general practice find their pool of full-time salaried doctors (aka slave labour) has shrunk and the need for locums has increased significantly.
Despite offering some of the best rates of pay available globally, young doctors no longer find general practice (or possibly any branch of UK medicine desirable) but not least because General Practice has become as much the battleground as any other part of the NHS.
A full-time principle in general practice can expect an income stream that approaches or even exceeds £200,000 year and with it, power and kudos. Instead of being the poor relations of medicine, scooping up all comers, Modern General Practice has taken on the attitudes of the Nouveau Riche.
To preserve its elevated status, General Practice has made itself the only specialty with a selection exam and an exit exam. There is no place for doctors who do not reach the threshold of these examinations. This applies to UK doctors as much as foreign competition. The pass rate is 80%. At the end of five years medical training, two years towards full registration and three years training in General Practice, there is one in five chance you will be unemployable in your chosen career. Modern General Practice demands first place on a doctors' list of career choices. It is a form of medicine dominated by computers, safety netting and guidelines. No wonder few medical graduates choose general practice.
My experience of returning to NHS general practice is not pleasant. Far from being welcomed back in the fold, I have had more obstacles placed in my way than on an army assault course. General practice is closed club and they do not want new members, least of all old members applying to rejoin. Those they want reflect those who they would like to be, young, bright and blonde supported by those who will not say boo to a goose. Unfortunately, being a dog, I am different from other trainees. I am slightly old to be a dog, having reached the grand age of 58 and three quarters years, and I am also old to be trying to get back into NHS general practice.
When I left general practice in 2011, the pay had dropped to £35 a hour and work was difficult to find. Another reason for leaving was the strict limits placed on target-driven consultation times. 10 minutes no more or less for each consultation. I had an attitude problem, that no problem I could solve in 10 minutes was worth my attention. I left when there were plenty of doctors in general practice because many medical graduates found general practice to be a haven from the developing chaos within the hospital service.
Over the last 5 years, it feels as though a crumbling system has desecrated and all but destroyed, in the manner of a religious monument captured by extremists in Syria or Iraq. Although General Practice claims to be patient centred there is no longer any evidence of that illusion. Not least, there is now, apparently, a shortage of doctors has become acute.
The GMC medical cull and the complexity of revalidation, the European working time directive, the trend towards part-time working and the generous pension arrangements available to doctors in their 50s and 60s have meant there are fewer doctors available on the shop floor. (Sherlock, being a dog, does not have a pension and is therefore not able to retire gracefully). Principles (the SME business owners) of general practice find their pool of full-time salaried doctors (aka slave labour) has shrunk and the need for locums has increased significantly.
Despite offering some of the best rates of pay available globally, young doctors no longer find general practice (or possibly any branch of UK medicine desirable) but not least because General Practice has become as much the battleground as any other part of the NHS.
A full-time principle in general practice can expect an income stream that approaches or even exceeds £200,000 year and with it, power and kudos. Instead of being the poor relations of medicine, scooping up all comers, Modern General Practice has taken on the attitudes of the Nouveau Riche.
To preserve its elevated status, General Practice has made itself the only specialty with a selection exam and an exit exam. There is no place for doctors who do not reach the threshold of these examinations. This applies to UK doctors as much as foreign competition. The pass rate is 80%. At the end of five years medical training, two years towards full registration and three years training in General Practice, there is one in five chance you will be unemployable in your chosen career. Modern General Practice demands first place on a doctors' list of career choices. It is a form of medicine dominated by computers, safety netting and guidelines. No wonder few medical graduates choose general practice.
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