I recently came to a disturbing realisation.
I am no longer a “new” GP.
It happened after I was facilitating a session at an event focused on supporting ST3 GPs as they transition into the workforce after GP training. A GP Registrar approached a colleague and I…
“We feel worried. We are looking to those ahead of us in our careers to see what you are doing about the government proposals for 8-8 working. We don’t see any action. Hospital doctors mounted a coordinated campaign against contractual changes. You don’t seem to be doing anything about it. Where is the resistance?”
I paused for a moment… I can calm his fears and provide some reassurance, I thought. It feels to me that in my area we have been doing a lot in anticipation of the push for 8-8 access. Of course, he probably just isn’t aware of it…
“Well”, I said, “Practices have come together and formed a federation. Essentially a company owned collectively by the practices. We have put together a proposal, based on available details of the likely service specifications, to tender for the 8-8 working. The intention is to deliver the service in a way that minimises negative impacts on practices and GPs who cannot, or choose not to, be involved, whilst enabling those practices and staff who are interested in being paid for the extra work to do so. Maximising the potential for improving patient access whilst minimising negative impacts on patients, practices and care.”
He appears unconvinced.
“The political impetus behind extending access means that it will happen. If a GP led solution is not provided, the work and funding will probably be handed to another provider, possibly from the private sector. They may well do a worse job than we would and further fragment and frustrate care.”
He doesn’t look nearly as reassured or impressed as I expected.
The term generation can be defined in a number of ways.
A “Biological Generation” is considered to be the time it takes from birth for individuals to mature and reproduce. In human terms, this is generally accepted to be about 20 years.
A “Cultural Generation” represents those people born during a specific period of time. They are often defined by their collective experience of significant social events. For example…
- The Lost Generation, 1883-1900, fought in WW1
- The Greatest Generation, 1901-1924, lived through the Great Depression and fought WW2
- The Silent Generation, 1925-1945, were children during WW2
- The Baby Boomers, 1946-64
- Generation X, 1965-1982
- Millennials (Generation Y), 1982-2004
For me, the Junior Doctor’s contract dispute of 2016 was something that I followed in the media. Like my hospital colleagues, I followed developments on Twitter and Facebook. Yes, I sympathised, I felt solidarity with my hospital colleagues, yet I experienced little direct impact.
There is now a generation of new GPs entering the workforce who actually lived the Junior Doctor’s strike. They took the difficult decision to strike, marched in protests and stood on picket lines. They have experienced a significant cultural event that I only watched from a distance and it seems that, at least for the moment, we may see things differently.
As contract holding small businesses, GP partners have always been in a different situation to salaried hospital doctors. We are vulnerable in different ways, in particular to competition from other provider organisations. But we also have different skills and tools. GPs are a varied bunch and some of us love the work others dislike. We have direct control of our practices, allowing quicker and more radical decisions to be taken when needed. There are fewer barriers to innovation.
I wonder whether the Junior Doctor’s dispute will have an enduring effect on the mindset of this new generation of GPs. Or will an ongoing experience of primary care align thoughts and attitudes toward my own?
Only the passage of time will tell.
For now, I am left with the knowledge that I am no longer as “new” as I used to be.
The Transitions2017 Day Conference was held to help new GPs to prepare for life after training. Videos of sessions and the story of the day are available here.
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