Ten years in general practice - Dr Abdul Zubairu

19 November 2020

I remember the day like it was yesterday, Wednesday 4 August 2010, my first day as a fully qualified GP. I arrived at the practice with a dry mouth and sweaty palms. What would I do, if I didn’t know how to manage a patient? What if I made a mistake? Would I get on with my fellow colleagues?

It seemed strange that just the day before I was a GP trainee who could draw on support from my trainer and now, I thought I was on my own.

Ten years on and I am still working full time in general practice and at the surgery I started in as a qualified GP. This is unusual as only 5% of GP trainees when surveyed intended to work full time in general practice after 10 years.

I want to share with you a few things I have learnt about general practice over the last decade. I hope that this will also help others to understand general practice better and give you an insight into what it is like to be a GP.

General practice is varied

Every day is different, and every day is interesting. It’s a real privilege to be a GP. You get to look after people from the cradle to the grave. You get to know your patients really well. I have a personal list size of approximately 2,000 patients whom most of them I have grown to know over the last 10 years. I know their families and how they interact with each other.

I get variety in the types of patients I see and also in the range of conditions that present. It really is a mystery as you do not know what is coming through your door next. The other variety you can have in general practice is the opportunity to create a portfolio career. I work eight sessions as a GP. I am also a GP trainer and involved in the education and development of GP trainees. I have a leadership role and act as medical director of our local GP federation (which is where a number of practices have agreed to work collaboratively). I also carry out some work for the General Medical Council with respect to setting questions for the Professional and Linguistic Assessments Board (PLAB) test. In the past I have had roles as an event doctor and a sports doctor looking after various rugby and football teams. The ability to have a portfolio career is valuable in my opinion as it keeps you fresh, energised and can complement your role as a GP.

General practice is ‘real’ medicine

General practice is as ‘real’ as medicine gets. As a doctor, we spend years in medical school learning about history taking and clinical examination. When we start hospital placements, often history and examination are paid lip service to and by the time the doctor has seen the patient, they have had a battery of blood tests and imaging investigations. I would argue there is nothing more ‘real’ than sitting in front of Mrs Jones and using your communication skills and clinical acumen to determine whether her abdominal pain is the result of irritable bowel syndrome, a urinary tract infection or appendicitis.

General practice can give you freedom

I believe general practice is the speciality that gives you the most freedom and choice over your life. You have a greater control of how and when you work. It really is a family-friendly speciality. I have three children and a wife that also works so on the days I need, I can schedule my surgery to start later so I can take my children to school. I don’t see any less patients on those days, I just start slightly later and naturally finish later. The flexibility is crucial for my family life and lots of other GPs value this aspect of general practice.

You really are a generalist

Your cardiologist’s primary concern is your heart, your ophthalmologist only cares about your eyes but as a GP you are central to a patient’s care taking into account their beliefs, external factors and expectations. Take for example a patient with diabetes may have the involvement of the GP, practice nurse, the diabetic specialist nurse, the endocrinologist, podiatry and the hospital eye service. Patients can often find it confusing and difficult navigating all the different health care professionals. As a GP, the relationship you often have with a patient enables you to help them to work out what is important right now.

General practice requires teamwork

Teamwork is vital in general practice. As a GP, you spend a lot of time seeing patients and completing paperwork. Over the last 10 years, there has been a significant shift in doing more things at a computer as most practices are paper-lite. Tasks such as signing prescriptions, analysis of blood results and dealing with hospital letters now take place with the GP sat at their desk in front of a computer.

You would be forgiven for thinking that you are on your own. This is not the case as within most practices you have other GPs, practice nurses, a practice manager, reception and administration staff. It is vital to ensure all team members feel valued and work effectively within the team environment. Our practice meets every day after morning surgery to discuss cases, have a chat, have a coffee and distribute home visits. This social interaction is vital for my sanity and helps build a good team ethos.

General practice requires leadership skills

Whether you are a GP principal, salaried GP, out of hours GP or portfolio GP you may need to develop leadership qualities. General practice is ever changing, possibly none so much that this year as a result of the COVID pandemic. All GPs can find themselves in leadership roles often without wanting to or going out to obtain these. You can sometimes feel like a case of ‘imposter syndrome’ so some experience during training would be useful. It is refreshing that the Royal College of GPs have now recognised the importance of leadership training and a small part of a final year GP trainee’s training reflects this.

GPs are required to keep up to date

Every doctor and certainly every GP is required to keep up to date with current medical evidence across the whole scope of their practice. Things change very quickly in medicine - guidelines change to keep up with the latest evidence, medications to treat conditions change and technology is constantly evolving to help GPs manage patients. It is vital that as a GP you stay up to date with all these developments. Annual appraisal is the process where GPs collate evidence to show they are keeping up to date and constantly learning. This is loved by some GPs but hated by others.

Conclusion

General practice is the bedrock of the NHS and without it the NHS fails. Being a GP is an exciting and varied career as well as being the only role in the NHS that delivers care for the whole person over their lifetime. All doctors have an important role in looking after the health of their patients. In terms of the one doctor that is going to be present throughout a person's life and has the opportunity to make the most difference over a lifetime, that is a GP. If you are someone who likes holistic care and wants to make a change to your patients, then general practice really needs you. 


Dr Abdul ZubairuPost by

Dr Abdul Zubairu

Dr Abdul Zubairu is a GP Principal at Norwood Surgery, Medical Director at Southport & Formby Health and Honorary Secretary for the RCGP Mersey Faculty.

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