What do you do to maintain your self-confidence?

10 December 2021

What’s the difference between self-confidence and arrogance?

Arrogance isn’t a nice characteristic in a clinician. We’re more effective when we make our patients feel good about themselves and we don’t do that by being superior or exaggerating our own worth.

But being self-confident is important, particularly for GPs given that we work in the zone of uncertainty. We spend much of our time making best-guess decisions and we’re better at coping with that reality when we feel okay about ourselves.

I’m becoming increasingly concerned about the self-confidence of the colleagues that I’m speaking to, particularly early career GPs. I’m hearing from clinicians who say they lie awake at night worrying about whether they’ve missed a diagnosis or mis-prescribed a drug, who are carrying out more just-in-case investigations and specialist referrals than they really think is necessary, who fear the lawyer’s brown envelope on their doormat when they return from work. In a recent College survey 35% of respondents said that at least once a week they are fearful that they can’t do their job anymore. That’s really worrying.

Workload pressures are one reason for the crisis of clinical confidence. The extent to which our specialist training prepares us for the current realities of the job is another. So too the lack of mentorship and peer-support.

So, what do you do to maintain your self-confidence?

Latest updates from your College

Covid update

The rising infectivity and probable pathogenicity of omicron shows how important it is to get the booster jab into as many arms as possible as quickly as possible, and GP teams are already making a huge contribution to delivering the newly expanded booster programme.

Following the Government’s ‘Plan B’ announcement on Wednesday, some patient groups have raised concerns about a possible return to largely remote appointments for non-vaccine related GP care and services. At present, NHS England has not issued a new Standard Operating Procedure for general practice, and the infection control guidance for primary care hasn’t changed. However, you will have now seen the NHSE guidance, issued last Friday, that aims to free up some of the capacity in general practice to allow PCNs to take part in the booster programme.

We are making it clear to politicians and the media that workforce shortages mean there aren’t enough of us to do everything, and that GPs will inevitably need to deprioritise some non-urgent activities in order to deliver the vaccine booster campaign. We are asking NHSE and UKHSA to clarify Infection Prevention and Control guidance as we move into a new phase of the pandemic and we’ll update you when we know more.

In the meantime, I have received a response to my recent letter to English Health Secretary Sajid Javid challenging his comments to a Health Select Committee that people are attending A&E because they can’t get face to face GP appointments. He didn’t address this point specifically, but has agreed to take up the opportunity to visit a GP practice and speak with frontline staff about the workload and workforce challenges they are facing, and we will be following this up with his office to arrange a date.

Separately, he has also sent a letter to the profession, thanking you for your efforts on the Covid vaccination programme.

#nottoomuchtomask campaign

The relaunch of NHS Confed's campaign #nottoomuchtomask on Wednesday proved prescient. The social media campaign asks the public to help keep healthcare professionals across the NHS safe by wearing a face mask or covering, if not exempt.

RCGP Annual Conference 2022

Planning is already beginning for next year's RCGP Annual Conference and you are invited to submit your ideas to present at the event, which will take place on 29 June - 1 July 2022 at Excel London. You’ll note the change from our usual October date and that’s because it will run in conjunction with WONCA Europe, hosted by the College.

2022 is also our 70th anniversary year.

All ideas, including those from College groups, must be submitted online.

Please note the various requirements on the website ahead of making any submissions. Closing date for submissions is 23:59 (GMT) on Monday 17 January 2022. Applicants will be notified of the outcome in February/March 2022.

7th Vasco de Gama Forum

28-29 January 2022 | Edinburgh

As we look towards a global view of primary care at our own Annual Conference in 2022, early career GPs can join their European peers to exchange ideas, learn about other cultures and primary healthcare systems across Europe. There’ll be keynote speeches from former College Presidents Amanda Howe and Roger Neighbour, plus workshops and presentations on leadership, remote consulting and writing for publication.

Read Dr Kerry Greenan’s InnovAiT article on her experience of the previous VdGM forum, and find out more about the Vasco da Gama group.

Full details.

Advanced Care Planning

Having 'What matters' conversations with patients enables personal wishes to be heard when they are planning for their death. This is something our Palliative and End of Life Care clinical lead Catherine Millington-Sanders has long championed - you can find out more about our work and conversations with EOLC partners and patients.

As part of our work on EOLC, the College has been consulted alongside other EOLC partners on the development of a public-facing online tool, ‘Planning Ahead’, to support individuals in Advanced Care Planning. It's being launched today as a work in progress, for public consultation. Hospice UK and Marie Curie are leading this work and will be collating feedback to refine the tool in order to ensure it is user-friendly, informative and supportive, and helps individuals think through some of the healthcare choices that may lie ahead for them, with the support of their healthcare advisers, including GPs. You can access the tool now.

You can register now for the What Matters Most Conference where you can hear more about the Planning Ahead tool.

Managing Drug and Alcohol Problems in Primary Care Conference

24-25 March 2022 | 09:00 - 16:30 | Zoom

Save 20% if you book by 20 December on this popular annual two-day conference, returning to the RCGP at 30 Euston Square in 2022. This is the largest event in the UK for GPs, shared care workers, nurses and other primary care staff, specialists, commissioners and researchers interested in and involved with the management of people with drug and alcohol problems in primary care. You can register now.

Telephone Consultation Skills

16 December 2021 | 09:15 - 17:00 | Zoom

This popular, longstanding RCGP course, delivered online, will provide you with a real understanding of how to manage the risks involved in telephone assessments to practise safely, effectively and efficiently. The day is entirely practical and will give you realistic tools and techniques in telephone triage and consultations by using interactive exercises, real calls, group work and plenary talks to explore what’s involved in providing care when we are unable to see the patient. You can register now.

Post written by

Professor Martin Marshall, Chair of RCGP Council

Professor Martin Marshall is Chair of the Royal College of General Practitioners and a GP in Newham, East London. He is also Professor of Healthcare Improvement at UCL in the Department of Primary Care and Population Health. Previously he was Programme Director for Population Health and Primary Care at UCLPartners (2014-2019), Director of Research & Development at the Health Foundation (2007-2012), Deputy Chief Medical Officer for England and Director General in the Department of Health (2006-2007), Professor of General Practice at the University of Manchester (2000-2006) and a Harkness Fellow in Healthcare Policy. 

He is a Fellow of the Royal College of Physicians of London and of the Faculty of Public Health Medicine and was a non-executive director of the Care Quality Commission until 2012. He has advised governments in Singapore, Egypt, Canada and New Zealand, has over 230 publications in the field of quality improvement and health service redesign and his primary academic interest is in maximising the impact of research on practice. In 2005 he was awarded a CBE in the Queen’s Birthday Honours for Services to Health Care. 

A co-founder and driving force of the Rethinking Medicine movement, Martin has a passionate commitment to the values of the NHS, patient care and ensuring the GP voice is central in a time of great change. When he’s not working, he likes being outside, preferably on a mountain or a coastal path with his wife Sue and their puppy. 

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