Who wants to be a GP?

I’m not sure I actually want to, however, this is my role. I am a human being sitting in a doctor’s chair seeing patients in much the fashion Roger Neighbour has described in his latest book ‘The Inner Physician’. Zooming in on pathological signs and zooming out to take notice of wider and social contexts relating to the consulting human being in front of me, whilst also reflecting on my internal resonance to aspects of their story.

Medical school was like square bashing for a raw military recruit who preferred the library of life. VTS an opportunity to explore wider skills whilst being sinisterly handicapped by multitudinous hoops to hop through. The first few years in practice were a scary and often lonely familiarisation process to what can blossom into a bountiful professional vocation.

No number of bureaucratic or political posturings or diktats can actually get in the way of the consulting process unless we as physicians allow it. On this we still have the ultimate sanction. Even to the extent of turning off the computer whilst conversing. Tick boxes can be ticked off. Wielding compassion and science whilst bearing witness to a fellow human being’s struggle in making sense of their sensations is a privileged and challenging part to play. We deserve equal attention too, although our training would like to blind us to this, our personal needs having been firmly boxed into the realm of ‘unknown unknowns’.

What the patient and politician want from their GP appears paradoxical and mutually exclusive. GP‘s have bravely tried to please all parties whilst bearing the burden of high rates of attrition: mental illness; addictions; divorce and suicide, seemingly in preference to betraying the basic need to be treated with the care and compassion they are expected to treat those consulting them. This is the area where the tensions of the job procreate, and which have been given as much attention as an elephant in the room. An elephant that trainee doctors are increasingly aware of, but whom politicians ignore whilst paradoxically piling on more carpets they then belabour with industrial carpet beaters to smooth out the wrinkles.

Is there anything to be done? Was it not always so? What can anyone expect in this time of financial austerity?

The recent Junior Doctor strikes have brought a new frisson of human rights to attention. Rights of patients and rights of doctors, the one to be treated safely by a safe other. Will truth trump politics and political spin this time for a change? I’m not holding my breath. Truth seems unpopular in a media which prefers sensational sound bites when not dancing to the tune of vested interests.

Looking after me to be safe for myself and my patients is something I have explored at length. This appears to be an individual task without a ‘one size fits all’ solution. The first hurdle for me was reaching the realisation I was worth it. A big ask coming from the culture which considered a female GP trainee falling pregnant to be repugnant and sanctioned intimidation and zero support in finding future hospital posts to complete their VTS. Would I conquer my fears? Could I dare admit I have fears!?

Resonances within me to patients’ stories helped me immensely. How could I continue to pretend I was so different from others? This realisation helped me become less defensive and reduced the importance to me of my role of ‘Dr’, a label it helped me to look on as a ‘human doing’. There was quite a time spent identifying the other ‘human doing’ bits of me which seemed to contribute to a sense of ‘who am I ?’. Many compassionate and caring folk supported me in this journey and to them, I have the deepest gratitude. Alone it would have been an overwhelming challenge and the reflection on the words ‘ill’ and ‘well’ offered was very useful. If you remove the ‘ll’ in each of those two words the clue emerges as to what contributes to each state.

Wishing you well in whatever you end up being.

Dr Andrew Sikorski

Dr Andrew Sikorski MBBS MRCGP DFFP FFHom.

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