General practitioners (GPs) are the first point of contact for most NHS patients. They deal with acute illness, preventable illness and chronic disease management. Working as a GP differs greatly from working in a hospital as you have to make a clinical diagnosis and work on a hypothesis rather than having results of investigations to work from. It’s a real intellectual challenge: the average consultation time is eight to ten minutes so you have to make complex decisions in a short period of time, and you don’t know what will be coming through the door next. It can be tough but is ultimately rewarding.
A typical day could involve arriving at work at 8.00 am for a four-hour morning session, consisting of surgery followed by home visits and paperwork. The afternoon session might then begin at 3.00 pm and last until 6.30 pm. In addition to surgery-based tasks, GPs also attend team meetings, either with other members of the practice or with GPs within the health authority. The number of home visits varies depending on the location of your practice – you would expect more in a rural practice or in an area with an aging population. A full-time GP will typically work nine sessions of around four hours a week. There is also potential for part-time work. Most practices will not insist on you being on call, but if you do choose to be on call, you would be expected to cover four to six hours on a weekly or fortnightly basis.
All GP practices in England belong to clinical commissioning groups (CCGs), which work to plan and design local health services. CCGs commission health and social care services including planned hospital care, urgent and emergency care, community health services and mental health and learning disability services.
Key skills and aptitudes
To be a general practitioner, you have to understand and enjoy all aspects of people and be able to cope with individuals of all ages. Being able to think on your feet is vital when required to make a quick diagnosis. The computer system for GPs is a lot more advanced than in any other area of the NHS; you can locate medical records within seconds but you need to have good computer skills to be able to use it.
Training and competition
There is currently a shortage of GPs in many areas so there isn’t a great deal of competition. However, some locations are more popular than others – it’s best to check with the deanery when applying. Pay has improved, with wide scope for part-time work and salary increases to match the salary of hospital consultants. The government has pledged to increase GP recruitment by 5,000 by the year 2020.
Best and worst
There is a great deal of flexibility in general practice, with the option of working part time. This is particularly useful if you have family commitments. It can be a stressful role, given the high level of demand for services and budgetary constraints, but you also get a great deal of job satisfaction and can implement new ideas relatively easily, as you are in charge of managing your own work schedule. The administration and paperwork can be a lot to deal with and while it is liberating owning your own business, if you come to sell your practice at a bad time, you may end up with negative equity if you own premises. Most new GPs like to rent their premises.