Thread by @AlisonGeorge10

1/14 I hesitated at voicing my opinion on this rather contentious issue…

But I feel that without individual testimonies, we will fail to understand why some GPs (myself included) feel mainstream primary care is no longer for them.

#GPCrisis
@HelenRSalisbury @MartinRCGP @rcgp

https://twitter.com/helenrsalisbury/status/1526505719503196160

2/ Obvs the relentless vilification from the MSM hasn’t helped, esp the claim by some that the number of ‘part-time’ GPs is the problem.

Those on the inside know that a typical day is 11-12hrs long & a ‘half-day’ is regularly 7-8, but hey, let’s not let facts get in the way.

3/ & I don’t suppose those of us who volunteered to work f2f in acute #COVID services within the community in spring 2020 will forget that our pleas for effective #PPE were repeatedly ignored & dismissed by govt, PHE, NHSE, HSE & senior advisors.

@CMO_England @MattHancock @UKHSA

4/ I’ve been a Dr for almost 32yrs, a GP for 26.
At 56 I have several more yrs to give, many more patients to care for & much more experience to pass on.

But I won’t return to ‘normal’ general practice while it continues to pretend that a #TotalTriage model is good enough.

5/ It isn’t!

IMV it is a poor 2nd best that isn’t good for the health & wellbeing of patients or drs.

It’s a high risk, low satisfaction alternative.
This isn’t because I don’t handle risk well or am inexperienced but because I feel it is a fundamentally flawed model.

6/ Advocates of #AskMyGP, #DrFirst et al claim it saves time & in the absence of enough actual bodies on the ground, it’s the best/only service we can offer.

I disagree!

& from a HCP perspective it’s still a high pressure profession but with all the good bits taken out!

7/ I have a number of concerns about its safety - missed diagnoses/delayed diagnoses/safeguarding issues/communication problems/digital exclusion/inadequate supervision & education of students/F2 drs/GP trainees …etc..etc.

8/ & the inefficiency of patients having to speak to multiple ppl before actually seeing a clinician is not insignificant.

Are the increased risks that the inevitable delays frequently result in, acceptable for healthcare in a HIC like the UK in the 21st century?

I think not.

9/ From the beginning of our journey through medical school we are taught of the vital importance of taking a really good history & then spend years honing our examination skills.

Imagine taking a history with a blindfold on?

10/ Not being able to see a patient changes absolutely everything.

Consider how important it is to know about a patient’s general appearance/size/gait/mobility/dress/expression/level of hygiene/odour/mental state/behaviour….

Again, imagine taking a history with a blindfold on!

11/ Consultations done by phone or e-consult will be missing most or all of those non-verbal cues!

Does that not concern you, because it does me…Enough to decide I do not want to spend my final working yrs doing a job I love, in this fashion.

12/ I suspect this is all part of the same #NHSPrivatisation agenda. Non-clinicians are pulling strings they shouldn’t even be touching whilst successive health ministers have failed catastrophically to do adequate workforce planning.

You get what you pay for!
@Jeremy_Hunt

13/ I’m not saying #TotalTriage isn’t useful or safe in all situations - medication reviews, sick notes & reviews of stable chronic conditions CAN be done very well this way.

But for new problems, complex patients, anyone w/ impaired communication etc it can be fraught w/ risk.

14/ Finally, this is absolutely NOT a criticism of my hardworking, exhausted & demoralised GP colleagues who are valiantly trying to hold up the system as it collapses.

I salute you all 💙

#PrimaryCare #MedTwitter #NHSCrisis🚨

@DrAmirKhanGP @DrNeenaJha @DrShanHussain @danielgoyal @dgurdasani1 @padsbigsis @DrYvetteDocGP @DrSimonHodes @Azeem_Majeed @CNagpaul @SC_HealthSocial @DHSCgovuk @ChrisCEOHopson @FRSAMatthew @AmandaPritchard @H_S_E @DRTomlinsonEP @doctorshaib @KateCushing2 @DrSelvarajah @DAUK_GP