Wednesday 12 October 2011: Annual General Meeting
Presidential Address: Dr Nigel Taylor: ‘The Patient, The Doctor and his Illness’
Venue: Kingsdown Conference Centre
‘When I started in General Practice consultations lasted for just 5 minutes and we could race through the patients. Now we have to spend ten minutes the throughput has really suffered’ bemoaned Dr Taylor with a touch of genuine regret.
He was discussing the changing role of doctors and their increased approachability compared with previous archetypes and was presenting us with his view on the changing face of General Practice.
In particular he remarked that the GP was having to take on patient concerns beyond the physical agenda. Indeed they were having to look into psycho-social areas over which they, as doctors, had no control. In some cases this even seemed to extend to mending the central heating controls in the patients’ homes!
There were many changes occurring in General Practice and not least of these was the role of GPs in commissioning, which, with the rationing agenda could mean the family doctor being compromised and receiving all the flak.
One major change was the feminisation of the medical workforce. When the President qualified in 1978 the percentage of female graduates was 25% but now was nearer to 80%.
Patients had also changed….. they had access to information in many books, on the internet and on TV.
Regulation had changed. For example the GMC used to worry about the three As.
- Alcohol (and other addictions)
- Adultery (particularly with patients)
- Association (with chiropractic, osteopathy, herbal and homeopathy)
Now the latter (Association) appeared to be encouraged and embraced rather than shunned.
Another change was that it had been acknowledged that long working hours could result in stress for the doctor.
The President had tried to persuade Bristol Council that adult exercise equipment in parks could be useful to improve the health of people in Bristol. They had reminded him that he could prescribe gym sessions. This he had done on occasion but few patients ‘cashed’ the prescriptions at the gym.
Dr Taylor discussed the remuneration for General Practice and pointed out that when all the perks of employment are taken into consideration the salaried GPs were as well off as the self-employed principals. The latter had to work longer hours and accept greater responsibility.
Discussing the broadened role of nurses the President wondered whether nurses acting in these roles were always as cost-effective as the employers thought. Their throughput was slower than doctors and the work they did deserved (and received) relatively high remuneration. Overall there was little gain financially but there was a shortage of doctors and nurses acting in medical roles were essential.
He also had noted that about the only thing that nurses were not permitted to do these days was to sign death certificates.
The happiness index showed that people were happiest when they had a household income of £50,000, owned their home and had two holidays a year away from their home.
His summary was that life is good in General Practice.