The Other Side

You see ‘a GP;’ a role who is there at your service to sort out your healthcare needs.

WHO is on the other side? Do you know? Can you see?

*****

What do you see? You had to wait to be seen. This annoyed you. What on earth is the GP doing? You grumble as you go in to be seen.

What is the other side? Patients keep arriving every 10 minutes over and over all day long.  Your GP is trying to keep to time but people keep coming in with lists, complex issues and mental health problems which can’t be done in the allocated time. The GP knows you don’t like having to wait. She feels guilty about this and stressed by it. She apologises even though it’s not her fault. The GP is adding ‘catch-up’ slots in to try and prevent patients having to sit in the waiting room so long which makes her whole day even longer. For you, the patients. Putting you first. But you don’t know all this. You can’t see.

*****

What do you see? You reel off a list or mention a big issue at the last moment or ‘Can you just….?’ You have paid your taxes. You are entitled to make the most of this service, especially as it’s taken you 4 weeks to get an appointment. It hasn’t occurred to you how much time this needs and that you are now making other people wait longer.

What is the other side? Your GP hates that you’ve had to wait so long for the appointment but can’t fix a system that can’t cope with the increasing demands on it. Your GP is worrying about how the other patients will be getting more disgruntled as YOU make them wait longer. Your GP wants to address all these problems thoroughly but there is too much time pressure so feels like a poor job is done even though you’ve taken twice your allocated time. Your GP tries to make sure your needs are put first and makes extra work for herself to do this….makes sure you don’t have to battle for an appointment next time. But you don’t know all this. You can’t see.

*****

What do you see? The GP only has a few hours of appointments twice a day. There is loads of time off in between. Most of them only work part-time anyway. What do they do all day? Why hasn’t my prescription or letter been done yet?

What is the other side? Your GP keeps going all day long seeing patients, phoning patients, doing home visits then straight back in to more patients and phonecalls. Usually without stopping to draw breath – the regimented timing of the system doesn’t allow it. There are no breaks. Lunch is a bonus but usually eaten at the same time as working. Finally the last patient contact is done. She draws breath. Now to sort and action the blood results, incoming letters, referrals to do, prescriptions to review. She has worked non-stop for 12 hours. So far. And still not finished. Finally, she stops, exhausted but still not finished. The rest will have to wait. Her young children have been put to bed now and she has missed it. Again. She is not part of their lives at this time of day. There’s all the housework to do when she eventually gets home – the family need looking after. She’ll be back at work again tomorrow to do it all again – but really can’t face it. The days are hard, stressful, long and emotionally intensive. ‘Part-time’ GP is as many hours as other full time jobs and extremely draining. On the days ‘off,’ she looks after her young children and plods through the work that needs to be done for the family, but can’t keep on top of it. This is not a rest. She has nothing left to give on these days and patience is thin; the job has sapped it all away. She feels like a rubbish parent. But you don’t know all this. You can’t see.

*****

What do you see? Your GP is there to talk to. Somebody to help you feel better. You feel in a dark place. Life is rubbish. It’s their job to deal with things like this.

What is the other side? Your GP ‘takes on’ your problems and emotions. She empathises with the pain your life is causing you and feels your tears. Sometimes, she wants to join in. She gives you the time you need, even though she knows subsequent patients will complain about waiting. This happens time after time every day. She is human too. She is giving of herself. But it chips away bit by bit. She starts to dread seeing patients like you as it is taking it’s toll. But she keeps going, giving her all at work, trying her best for her patients. But you don’t know all this. You can’t see.

*****

What do you see? You had to wait ages in the waiting room today. The doctor seems to be all over the place. Doesn’t appear to be taking things in properly. Nearly forgot to give you the prescription.

What is the other side? Your GP is human too. Your GP is not infallible. Your GP was trying to get through the day whilst feeling unwell herself. She has a chronic disease too and a virus at the moment on top. But she is desperately trying to put your needs first. But you don’t know all this. You can’t see.

*****

What do you see? The wait for the appointments, the wait in the waiting room, the referral or procedure you can’t have because the NHS can’t afford to fund it, the referral that’s been done but there’s no appointments available because the system is pushed to the limit, the wait for prescriptions and letters to be done, increasing prescription fees. ‘It’s not good enough.’ Whether it be you’ve paid your taxes or you’re eligible for free prescriptions, you want to milk everything you can out of the system; because you think you are entitled to.

What is the other side? Your GP knows you are frustrated and completely understands. Your GP and her family have medical problems too. Your GP waits for GP services. Your GP waits for hospital services. The system is pushed to the limit and failing – she knows it’s not good enough. Your GP can’t fix it. Your GP is also frustrated because she can’t meet your needs in the way she wants to. You’re making it worse trying to get every little bit you can out of it. It is a vicious cycle. You could help by remembering the big picture and taking as little as you really need to allow the system to recover a bit.  Use other resources. Your GP makes the effort to try to explain this for the greater good before the NHS fails altogether. But you don’t want to listen and understand. Your GP chose this job through the innate desire to help people and used to feel like she could do this and enjoy it. Now, not only can she not provide the service she wants, but the patient frustrations and overall negativity has made the whole thing a trial. She looks for a way out as several more decades of this fills her with horror. There is no way out. This is the only job she knows and she has to provide for her family. She has to keep going. But you don’t know all this. You can’t see.

*****

What do you see? Your GP is off sick. Probably a chest infection or something. She’ll be back soon.

What is the other side? No it’s not that. Your GP has nothing left to give. She is broken. But you don’t know this. You can’t see.

Advertisements

33 thoughts on “The Other Side”

  1. I’m seeing this all around me. Some patients have no idea. I hope many will read it and take it on board. I fear most won’t and the sense of entitlement will continue until there will be no service to be entitled to!

    Liked by 1 person

  2. Terrifying, heartbreaking but all too true: the background story to many GPs these days.
    Been in a very similar situation and totally burnt out, but old enough to take early retirement – still taken 3 years to recover.

    Like

  3. This is a very true reflection of the life of a GP today, they never stop and very rarely complain. Too much emphasis on meeting targets and budgets, not what they signed up for. Something needs to be done before the whole system goes into meltdown, but what, I dont have the answer to this.

    Liked by 2 people

  4. Very well written. Thank you for writing this as it resonates my real feelings and emotions. I felt like this when I was a GP Reg, burnt out and broken. I am feeling much better now that I am locuming and I dont think I can sacrifice my own self and family as a salaried or partner in the current NHS. I am also emigrating for my own sanity and better work life balance. I hope you’ll feel much better soon. Xx

    Liked by 2 people

  5. I hope enough patients read this. The concept of human struggling doctors needs to be highlighted as the NHS is haemorrhaging doctors at the moment and the public seems to be falling for Hunt’s totally illogical and unrealisitic promises to recruit thousands more (non-existent doctors). We all need to put ourselves and our lives first…oxygen mask on you before any dependents. Hope you take the time to heal and be back to yourself x

    Liked by 1 person

  6. I have been the patient rep for my surgery for a number if years. We are so lucky to have dedicated people who care for us. The government has made it into a business not a vocation. Medicine has changed over the years and now much more is expected of the GP. How much does the government give them to do everything? £145.00 per year per patient to provide everything you get. It’s less than 40p per day!
    The government controls how many doctors can be trained. The conditions they work in are appalling. We stop drivers after 4 hours to have a break. Doctors in hospitals are meant to have 30 minutes after each 4 hours. They don’t get it as you can’t stop in the middle of treating someone and have a rest. We are bringing the NHS to its knees.

    Liked by 1 person

  7. Well written and truthful- this was why I took early retirement.
    The only thing I would take issue with is that it is not the patients faults, of course they want all of their concerns dealt with and ASAP.
    It is the fault of a Givernment which deliberately underfunds the NHS for idealogical reasons and NHSE which allocates a dwindling percentage of this budget to Primary Care because we are less visible to the media until we collapse completely.

    Liked by 1 person

  8. Yes. This is what it was like when I finally broke. Problems at home, so much responsibility and then a continual moving of the goal posts, demanding more and more. The patients and staff were not the problem. It was the continual trying to “prove” you were doing your job that finished me.

    Liked by 1 person

  9. As a tired psychiatrist – consultant since 1995 and thinking about early at least partial retirement – thanks for writing this, immense respect and sympathy to colleagues in General Practice. mental health services are the same perhaps in a slower motion but also past breaking point. Hard times and changes are coming that I think the country will regret.

    Liked by 2 people

  10. I have written a play called `Remedies` in which a GP whose wife has something like ` M E`, and whose colleague suffers from severe depression struggles with his wife`s well-meaning cousin who proposes all kinds of alternative treatments, from homeopathy to radionics. (Look it up!) In the play I also mention Balint groups – support groups for doctors with particularly troublesome patients. If you are interested to hear more of the above do be in touch. I would be interested to have an objective GP`s opinion of the play. Not yet produced, but interest from a well-known fringe venue in London. Deborah Freeman http://www.deborahfreeman.co.uk

    Liked by 1 person

  11. This is so true – we had the most amazing doctor but he retired at the age of 62 totally burnt out . We miss him, his kindness, his care and commitment. Please do not take the NHS for granted it is privilege not a right.

    Like

  12. To anyone reading this who doesn’t like the sense of patients being at fault in part or not understanding that we are people too, please understand this was written the day after I crashed psychologically. Rationally I know there is a negative bias to what I have written and that I have probably written the worst case scenario; I know it does not apply to all patients. I wrote it for myself to try and make sense of some of the disordered feelings spinning around my head. These are the things that dragged me down. I chose to share it later and more widely once I realised it was helpful for colleagues to read who can identify with it.

    Like

  13. Please don’t apologize for writing this. It’s a beautifully written and honest piece and I don’t read it as critical of patients but rather of the system and the ridiculous expectations it places on many GPs.

    Like

  14. Completely ridiculous what the government is doing to the NHS. How anybody can work here is unbelievable. Maybe a public/private split will make life better for GPs?

    Charge patients more to see them for longer periods of time and give them better care i.e. the concierge model of medicine that seems to be working fairly well in the US.

    Just a thought. I would be jumping on board this model if it ever became feasible.

    Like

  15. Thank you for being brave!

    It also took me a while to get on to meds. I tell patients all the time that it’s just like any other physical chronic illness that needs to be treated. But somehow I kept “missing” my GP appointments to talk about meds. I didn’t want to take the meds because then it would mean things were really that serious. “I’m just in a rut because I’m not good enough at this job.” I obviously didn’t have insight into the hypocrisy of my subconscious.

    I’m glad you’re getting help!!!

    Hang in there. Things do get better.

    Like

  16. I like the honesty in this post and I understand dealing with frustrated patients is wearing (I’m sorry that this happens) but in some ways I don’t see how this is different to a mother and wife doing any other job. The 21st century demands a lot of women, juggling work, family and mental health. I’m not a GP but I have to do all that, I know most of my friends do too.

    I don’t expect my GP to not be human, I prefer you human. As always, two sides to anything. Some frustration may occur because when at work the standard time out for an appointment is 1 hour, that includes travel. Delay then means the patient may have to make up work time later & that has a knock on impact for them.

    I would say unfortunately, I have encountered some very rude receptionist when I have been late for an appointment. Consideration & compassion are needed on both sides, having depression and a newborn & being reprimanded for being late (but still in the appointment time) is not pleasant or helpful. I’m a firm believer in never judging a man till you’ve walked two moons in their moccasins. Some days neither side can know what day the other person is having. It is important for anyone to take rest and holidays to prevent burn out. I’m not saying there are things in the NHS that don’t need addressing. I’m grateful for my GP & I know life is tough, but life is also tough for many others in working roles, we are all human after all as you say.

    Like

    1. I completely agree with your points in the most part. This was written as I completely fell apart. Therefore there is a negative bias. I very much see both sides of the situation normally and many patients do understand – but many don’t. It is true that lots of people in all walks of life struggle to do it all. What I would say is unique about being a GP, is the highly emotional one-to-one contact with strangers 40 times a day organised into ridiculously small time segments that are impossible to keep to. The job is getting increasingly pressured month on month – 3 years ago, it was fine. Resources are dwindling, demand is soaring exponentially and there are less of us than there were. Even hospital work wasn’t as stressful as this. I had even looked at trying to find something I could do without the direct patient contact to replace one of the sessions/week. This was the first blog – reading the subsequent ones might help put it into context if you are interested.

      Like

  17. You aren’t alone in going through it. I’m in my 40s and my career as a functioning clinician is over because of burnout. There’s a lot that’s due to system issues – I live in the “other London” (in Canada) and it’s no better across the pond – but the grind of the job and emotional demands just wore me to the bone. I can only imagine what it’s like with the added pressures of womanhood in the mix.

    If you’re interested, I have a memoir of my own experiences in medicine, including my bouts with mental illness, pain, and burnout. Even if the book isn’t for you, you’ll probably relate to stories on my website. http://drwarsh.blogspot.ca/p/the-memoir.html

    Hang in there.

    Liked by 1 person

  18. Thank you so much for writing this. I’ve lost count of how many times I’ve said to others waiting past their appointment time that I’m more than happy to wait for my appointment because it means that my doctor is doing their best to give every patient as much time as they need. If I’m kept waiting for 45 minutes for my 10:30 appointment then that means my GP has no chance of getting lunch, they’re massively stressed because they know they have grumpy patients waiting for them, in many cases all they can do is say ‘I’ll refer you to x service but they have a (insert number here) month waiting list. They know that patient will be back, still in pain whether mentally, physically or both because they will still be waiting so that’s another primary care appointment taken up by a condition that should be being overseen by a specialist. The specialist is having exactly the same problems apart from it’s not 45 minutes that their patient has been waiting but 45 weeks, for something that is now chronic. I love the NHS, it has saved my life 5 times, my son at birth and my daughter 4 weeks ago. The level of funding, criticism and scapegoating by a succession of governments is despicable. I am in awe of those who work on the front lines and continue to come back in to work day after day.

    Liked by 2 people

  19. I commented yesterday but it got lost somewhere in the ether.
    Your situation must be so hard to tolerate 😦
    It’s an unfortunate situation that people like me don’t get what they need from a GP…..you see, my expectations are very low….as is my self esteem. I try to take up as little time as possible, don’t go as often as I need to and don’t say everything I probably should say. I’m frightened of doctors, frightened of people in general and so it’s a hugely stressful thing for me. I always used to make a list, so as not to forget but a while ago got told off and instructed to make separate appointments for different things. This is unviable, I would be there all the time, which is in itself unviable because I just haven’t got the physical and mental ability to do so. I would feel like I was taking up even more of her time, worry that it would annoy her and perhaps give her the wrong impression. I don’t think I’m worthy of a home visit either. I’m 66 next week, chronically ill, physically and mentally and disabled, spending the majority of my time in bed. I can only go out in a wheelchair but as I do go out, though not very often, I feel it would be wrong to call the GP out. I have several conditions and feel terribly ill all the time but my GP has told me on several occasions that I’m never going to get better, only worse. I feel that patients like me are seen as a waste of time 😦 A counsellor told me that I need to ask for referrals to experts/specialists for my conditions, in case they can help or refer me for special treatments. The appointment is made and I’m terrified that I’ll be in such a state, I won’t be able to convince her. I’ve always had a great respect for the medical profession but I have to say that although some of them have been angels, others have been downright horrible. I believe absolutely that there needs to be mutual respect and understanding. Thank you for being a dedicated doctor and I’m so sorry that you’re not valued more.

    Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

w

Connecting to %s