I did my last GP locum slot on the 30th December and followed it with a resolution – it really would be my last. So now I am lost to general practice for good.
What prompted me to do this? Well, I have to admit that HMRC telling me that I owed them quite a lot less than I feared had something to do with it. But also I have come to realise that working only 8 sessions a month really isn’t enough to keep one’s hand in as a GP – things are changing so quickly and you really don’t want to see a doctor in 2012 who is practising the same as he did in 2002 now do you?
And the reason I was only doing 8 sessions a month is that my defence organisation – the bods who come to doctors’ aid when they get sued – said that with my reduced sub (over £150 a month) that’s all I could do. I got miffed – I must have paid them pretty close to £100,000 in subscriptions in my 42+ doctoring used and got nothing back. That is, although I may have deserved it, I never got near being sued by a patient in my whole career.
But to get back to the point: to really keep up with trends and changes I guess that I would need to be working double that. But I couldn’t afford the defence subs and quite frankly I don’t have the energy and staying power I once had.
And there is another point: for me, the looming spectre of regular revalidation for GPs, necessary though it is in principle, is a real block to effective learning. Yes, really, even though it is about keeping doctors safe and up to date. But they have gone about it in a way that is crass, cumbersome and costly: requiring doctors to undertake audits of their work, engage is 360 degree appraisal by colleagues and staff, promising to improve themselves in line with comments made by patient questionnaires. And much other similar crap.
Look – I was a GP educationalist in my time, and a damned good one. I know as much as anyone about identifying learning needs and acting upon them. I did it conscientiously and with rigour. When I was allowed to. But now the meddling politicians have decided that they know best. Such a pity, as the resources available to practising doctors now for ongoing learning are phenomenal. And believe me, most of them engage with them with huge enthusiasm.
Funny – my own enquiring of the general public leads me to conclude that very few of them are aware that their doctors are going to have to devote a considerable amount of time – which they would prefer to spend with their patients – to a revalidation process that is unproven and is going to cost somebody a hell of a lot of money (don’t worry – it will probably be the doctor). And any process of assessment that is worth anything at all is going to have a failure rate which means that doctors will be removed promptly. So if you pitch up a the surgery with your chest, your feet or your piles and the doctor isn’t there, then you’ll know why.