Reasons to be cheerful for 2014

Happy New Year! 

Best to put 2013 behind us.  It was a hard year for the profession.  There was a constant barrage of negativity laid down by politicians and the media – paid too much, working too little and responsible for many of the ailments eroding the NHS. 

Of course none of these is true.  But negativity sells papers and allows politicians to undermine and further their own murky agendas.

But 2014 is upon us and it is time for a change.  So turn off the TV, throw that newspaper on the fire and, for the love of God, don’t go on any internet forums because there are reasons to be positive!

Patients actually still like us and value what we do.

Did you get a card or a present from a patient this Christmas?  I bet you did.  Is this the action of people that despise the profession?  Of course not.  Regardless of the rubbish you may read in the paper, the vast majority of people appreciate the work we do and believe we are good at it.

The latest GP Patient Survey shows exactly that.  Published in December 2013, 92% of patients had confidence and trust in their GP.  Despite a year of overwhelming negativity, when you ask the people that we help day in day out, the people that really matter, you get a positive reply.

Less bureaucracy

With around a third of QOF dropped for the 2013/14 contract (in England at least, with the rest of the UK likely to follow in time) and many onerous tasks such as QP shelved, there is a swing back to patient contact rather than computer contact.  While getting a feel for what will be necessary is going to take time, this feels like a step in the right direction.

Our skills are more vital than ever.

Over the past decade we have seen the rise of the guideline.  Evidence-based medicine has become, quite rightly, the benchmark of good clinical practice, but has been often misappropriated by the establishment, particularly through QOF.  Too long have we been shackled to guidelines.

We should never forget that evidence-based medicine is about using the best available evidence together with our own experience and that of our patient to address a problem.  Nothing in primary care is ever black and white.  No guideline should be blindly followed.

The growing recognition of multimorbidity and polypharmacy (which we will cover on the Spring Hot Topics course) herald the emancipation of our profession.  Patients with multiple chronic diseases are the norm and a growing body of research explains that a one-size-fits-all approach will not work.

But more research cannot give us all the answers.  As one delegate pointed out last year: “I feel sad that this even needs to be researched.  This is our job.”  No study will ever be able to usefully address the endless permutations of patients with different conditions, different medications, different lives – which is why our experience and skill is vital to work out what is best for that person and can never be replaced.

Thinking positively
Anyone who has ever done Mindfulness will know that by simply smiling we feel better.  It’s a cheap trick but it works.   So, let’s not focus on the negatives – focus on the good bits.  Once we are positive about ourselves then we, our staff and our patients will start to feel good about what remains a great profession.  I for one am glad to be a GP.

Neal