The GP is not just a GP. He or she is also a counsellor, an advocate and life-long confidante who cares for their patients during some of the most vulnerable times of their lives.
GPs are in it for the long haul, with many caring for patients from the cradle to the grave.
This extract and the following case study is taken from an article I came across in the Irish Times written by June Shannon. The article was published a couple of years ago in 2017.
In the article, June interviewed a number of GPs and asked them to describe a typical day for them working in their various Practices.
I will summarise a couple of them, as for me, they are an excellent representation of what goes on in General Practice up and down the country on a daily basis.
“The petrol tank is empty. It is starting to splutter and come to a halt”
started work at 8.30 am and used the time before her first appointment at 9.15 am to catch up on paperwork. This included filling out forms for a carer’s allowance and a medical card application.
She also reviewed blood results, received phones call from a pharmacy and a nursing home, dealt with an emergency where an injured patient needed to be referred to the urgent care centre, filled out prescriptions and reviewed a medico-legal report.
She then started her morning surgery which included dealing with a diverse range of cases from ante-natal checks to dealing with mental health problems and everything in between.
At 1 pm, Dr Favier spent two hours doing more paperwork, including hospital referrals, prescriptions and a housing support letter for one of her patients at risk of becoming homeless.
At 2.30 pm, Dr Favier had a sandwich at her desk while she dealt with emails and reviewed more blood results.
At 3pm, the afternoon surgery included cases of conjunctivitis, a check-up for a new mother and her six-week-old baby, an elderly diabetic who had recently suffered falls and also needed bereavement support, a dental abscess, women’s health, a patient who had suffered periods of unconsciousness, another who was suffering with anxiety and depression; a patient with chest pains, another with fertility issues and an elderly patient who required a referral to the local falls clinic.
At the end of the day’s surgery, Dr Favier returned phone calls to patients, dictated three letters and filled out more prescriptions. She finished work at 6.35 pm and admitted that she had not managed to clear all the day’s paperwork.
“The GPs don’t need lots more money but general practice does. We need proper funding, we need advanced nurse practitioners and we need proper protocols.”
Dr Favier describes the pressures of a busy practice as “a constant fog” and like many of her colleagues she worries about “dropping the ball”.
“All GPs talk about it all the time, that they have a slight background anxiety that they are just running so fast
that they are bound to neglect something.”
“The petrol tank is empty. It is starting to splutter and come to a halt and in some places, it is off the road. If something is not done you won’t be able to put it back on the road.”
From my experience, this is typical of many GP Surgeries throughout the Country. Depending on the size of the Practice, some GPs have no choice but to manage the significant administrative burden while others may have more support in assisting with some of the paperwork.
Without exception, all GPs want to be able to concentrate on patient care but they also need to focus on the business and unfortunately for many, there are not enough hours in the day! They are wearing multiple hats, which include juggling finances, managing staff and treating patients as well as dealing with the ever increasing administrative burden associated with patient care.
Dr Sinead Cronin GP
“Patients expectations are higher than they have even been. We live in a society where everything is instant”
– Dr Sinead Cronin
Dr Cronin says she loves her job as a GP, however, she adds it is “probably more difficult than I ever really gave it credit for”.
“We are expected to do more and more with less and less. And I think patients’ expectations are higher than they have ever been. We live in a society where everything is instant and when you have to explain to somebody who hasn’t got health insurance – look, you are going to be waiting nine months to see a gynaecologist for that fibroid – people don’t understand that, because it is not the way they operate.
“I don’t apologise for the system that we work in, it is what it is and I would make it better if I could. I think that part is tricky, and it is all about managing patients’ expectations,” Dr Cronin adds.
Dr Austin O Carroll GP
“All the evidence shows that there is not enough doctors in areas of deprivation and isolated rural areas”
– Dr Austin O Carroll
According to Dr O’Carroll, while general practice has always been a busy job he has noticed an increase in the amount of preventative care provided by GPs. He also estimates that up to 6 per cent of patient consultations is taken up with filling out social welfare forms and writing letters for housing or clothing benefits, part of which is not covered by the GMS contract.
As a GP in an area of high deprivation, Dr O’Carroll cares for a population with a very high burden of illness: these include those with chronic conditions such as COPD, HIV and Hepatitis. For example on the day he recorded, Dr O’Carroll saw between three and four people with HIV and the same number again with hepatitis.
That would be very unusual in any other practice but a daily occurrence for us, he says.
“I think we are in facing a crisis in general practice because we are not producing enough general practitioners, and the older GPs are working harder and getting more stressed. I definitely am working longer and harder than I did when I started and I know several doctors who have retired early.”
What do these GPs have in common?
The common denominator between all of these GP’s is their focus on patient care. Location, patient demographics and access to resources for themselves and their patients are what generally separate them.
There are many similar articles that you can read outlining ‘A Day in the Life of a GP’ and regardless of the frustration that is expressed by some, the overriding sense is that the patient is paramount.
The large amount of paperwork GPs are required to do was something all the doctors interviewed for this piece reported as becoming increasingly time consuming.
Every GP talks about ‘time’ as being their biggest challenge and from my experience, some practices achieve a reasonably good balance for the most part, however, many remain on a fast moving hamster wheel.
How Can Best Practice help?
Best Practice works with GP Practices and helps them to implement systems and standardise processes to save time, so that GPs can be the Doctors that they always wanted to be and that patients continue to receive the care that they deserve. This is done using proven Practice Management Techniques, Business Consultancy & Tailored Staff Training.
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Full link to the article can be found HERE