No I’m not expecting it to be walk in the park. It’s going to be astonishingly hard work, with difficult decisions, a high degree of uncertainty and a healthy dose of second-guessing decisions made in 10 minutes that really needed 15 minutes of thorough appraisal.
But that is all part of what makes being a GP so rewarding. It’s not easy, you have to be able to think on your feet and make decisions that are life changing for the patient.
Those decisions aren’t always lifesaving, although it can happen, but life changing. Such as being the only person a young isolated mother can talk to about her concerns for her child’s speech impediment, agreeing the adjustments to a fit note so the 59-year-old man can return to work and adjusting an elderly patient’s medications when they finally confess they can’t open the child safe bottle.
With an inherently inquisitive mind, repeated similar presentations in some hospital specialities didn’t inspire me to ask questions, dig deeper and search for the link between presentation and pathophysiology.
In contrast, with only a brief history and basic investigations at your fingertips a GP can decipher which of the 32 differentials of a headache is the correct one. The ability to reach into a vast bag of knowledge and pick out the right differential is an incredible feat and a skill, that as a medical student, I am only beginning to develop.
Although it might not be a spoonful of sugar to go with the medications you’re prescribing, clear accurate instructions with a discussion of the advantages and disadvantages is just as important in an age of polypharmacy and antibiotic resistance.
It’s more than that however, just like Mary Poppins, a doctor is authorised entry into some of the most private areas of our mind and life. This allows us a huge privilege and enables us to become far more than just a doctor. We become members of their family, advocates, bearers of bad news and path finders amidst a mountain of paperwork and jargon that often accompanies housing support or social care input.
The bottom line is I want to know my patients.
That sounds silly, doesn’t it? I want to know their fears, hopes, dreams and everyday misgivings, because if I do I can treat them as person and not as a disease. Hospitals can be scary places for patients, whereas the small room of a GP can be a haven, a sanctuary, a place someone truly wants to hear what you have to say.
Although general practice isn’t seen as the exciting, dramatic side of medicine, to me it is the most important and I hope to help teach the next generation of medical students that general practice is where they can make the most difference.
- Georgina White is a 4th year medical student at the University of Birmingham