Career Questions

What made you want to become a doctor?

When I was nine years old, I shut my finger in a door, and I was missing the end of one of my fingers. I spent many weeks in the hospital having plastic surgery, and it was at that time I decided I wanted to become a doctor.

What skills do you need in order to be a Doctor?

The skills you need to be a good doctor depends on the field of medicine in which you are practicing. For me as a GP one of the most important things to be a good doctor is to be able to talk to my patients and to be approachable. For other people, such as surgeons they have to be good with their hands. With brain surgeons they have to be incrediably good with their hands and be able to perform very delicate maneuverers. Others need to have a very good scientific brain and be good with computers, so there is a very wide range of things you can to In order to be a good doctor in the field of medicine, depending on your own particular skills.

How long does it take to become a Doctor?

It takes either five or six years to become a Doctor, depending on the type of course that you do. If you do a scientific degree in the middle, as I did, it takes six years. Otherwise, it takes five years, but that's just to get basically qualified. Once you have qualified, you then have to have a probationary year as a house officer before you can become fully registered with the General Medical Council.

What additional qualifications do you need to become a GP?

I don't think scientific ability is all there is to it. You also need to be able to relate to people. Medical schools increasingly are not just looking for the clever buffons, they are also looking for people who can talk to patients and have humanitarian approach to other people.

What is the most satisfying part of being a GP?

To me, the most satisfying part of being a GP is to watch people get better, to relieve their pain and, rather strangely for me, it's also giving people a good death. Death isn't something we like to talk about but it's something that has to happen to us all at some stage or other, and I get great satisfaction from seeing people leave this world peacefully and not in pain.

What is the most difficult part of being a GP?

For me, the most difficult part of being a GP is patients who are aggressive, who are rude to me, argue with me, and don't listen to what I say. Sometimes I wonder what on Earth they are doing there in my surgery because they are clearly not interested at all in my expertise as a doctor. They've just come in to demand what they think they need. Sometimes they're right but quite often they're wrong. Trying to get that message across is very difficult.

Do GPs work long hours?

GPs used to work very long hours indeed. Not so long ago I was working day and night at least once or twice a week. Now GPs are working better hours. We generally start 8 or 9 o'clock in the morning, don't go on much more than 7 o'clock at night. But the day can be very intense so it's not an easy career and you have to have stamina.

What kind of holidays do GPs get?

What holidays you get depends on the type of general practice you're doing and the arrangement you have within your practice. I have 6 weeks a year which is quite generous. That I think is about standard. If you're working as an assistant you may get 5 weeks a year. The holiday entitlement is normally good but it's recognized we're in a very demanding job where we're needing to be sympathetic to people and we do need to get a break.

When can a GPs retire?

As a GP, you can actually retire whenever you like, but you have to bear in mind your pension provision. There's a very good pension within the NHS, but to get full pension provisions, generally you need to keep working until you're about 60. You can buy added years, which means you can retire sometimes a little bit earlier. It really all depends on your personal financial situation.

Are GPs paid per patient?

The way GPs are paid is actually quite complicated and it also depends on how you are working as a GP. Increasing numbers of GPs are what is called salaried assistants which means you are just paid a basic salary like other healthcare workers. If you are a partner in a GP practice, what you do is you take a share of the profits of that practice and the way the practice will earn money is partly by the number of patients on the list, partly by the services you provide for those patients and how well you're providing those services. And also whether you're doing any private work, whether you're doing insurances reports, whether you're doing medicals. So it's really quite a complex subject of how you actually get paid.

What do you do in your average day as a GP?

In my average day as a G.P. I do a 3 hour surgery in the morning. I then do at least an hour of paperwork which is the bit that often gets forgotten. I have letters to write to the hospital consultants. I have letters to read from hospital consultants. I have results to check. Patients also often want contacting by telephone. They want me to chase results for them. So after every surgery, I spend atleast an hour sitting at my desk doing administration. There are then home visits that have to be done and they vary from day to day, sometimes as one, sometimes as three- depending on the analysis. I generally then get an hour off in the middle of the day but that may be taken up by meetings withing the practice. Meeting the practice nurses or meeting other health care staff. And then I have another surgery in the afternoon again 2 hours or 3 hours and another pile of paper work. And then also the repeat prescriptions that need to be signed and in my surgery we have a rotor who does that. But when its my turn to do repeat prescriptions thats another half to one hour job, depending on how many there are.

Do you ever have to deal with hypochondriacs?

Hypochondriacs are a regular part of a GP's workload. We get quite good at recognizing when people are particularly anxious about their health and generally we don't try to label them as hypochondriacs. We try to work out why they are so anxious, and do things to alay their anxiety so that they can enjoy their life a bit better, without worrying about every minor sympton and every lump and bump.

Whats the most shocking thing you've come across as a GP?

One of the most shocking things I ever came across as a GP was and please, don't try this at home, is a woman who had a mango in her vagina. Quite what it was doing there it was not my business to ask. But that was quite interesting.

Do you have to be unshockable to be a GP?

It helps to be unshockable no matter what part of medicine you are working in but particularly as a GP because you'd be amazed at some of the things I come across in my day to day life. Things that you wouldn't believe if you saw them on television, I have had in my surgery.

How much psychology is involved in your job?

There is a lot of psychology involved in being a GP. Some things are very straight forward but quite often, there is a psychological element. People who are coming in and complaining of tiredness, people who've got headaches, people who've got irritable bowel syndrome for instance; quite often there's a heavy psychological element. Increasingly there are people with very obvious mental problems, stress, anxiety, depression; all having to do with working in a very high pressure environment or living a high pressured life. People are unhappy because their partner's have left them. We don't seem to have stable family networks anymore and that seems to create its own problems. So psychology is a very integral part of my job.

How much tact is involved in your job?

To be a GP you've got to have a huge amount of tact and you've also got to learn when to just shut up and listen, and when to make little comments to try and encourage people to talk to you a little bit more. People don't come to their GP to be told off or to be chided, so you have to remember that, that you are there as the friendly family doctor who is there to help somebody and being untactful is not part of the remit.

Do you ever feel under pressure about making certain diagnosis?

I quite often feel under pressure from patients to prescribe drugs, and particularly antibiotics, which they don't need, and trying to explain to patients that they don't need a medicine, that they need to let nature take its course, can be very difficult indeed, and it is amazing how people expect me to be a magicican and work wonders. For instance, they want cures for the common cold which just don't exist, and they demand prescriptions which aren't going to help them, and trying to say to them, "You don't need any medicine. What you need is a good rest, some sleep and for your own immune system to do the trick", can be very difficult indeed.

Are you ever under pressure to hit government targets?

All GP's are now under a huge amount of pressure to get information onto the computer for what is known as The Quality And Outcome Framework Points. It is to do with people's lifestyles and also to do with managing particular diseases. So this is why when a diabetic comes into the surgery, I will start asking them some rather obscure questions sometimes, about their mental state. And when are they depressed. I think all GP's are getting increasingly annoyed about the coif points, as they are known as. And they come up in red lights on our computers. And certainly I joke about them with my patients. But I do get upset when instead of sit and listening a bit longer to a patient's problem, I have to start ticking boxes.