GP workload is no fairy tale

I have never disclosed this publicly before (to avoid the paparazzi) but, as a baby, I was of royal blood, closely related to the Dauphin.

Unfortunately, on the day I was presented to the adoring masses, the ceremony was hijacked by an evil fairy, who stole me from a life of Parisian splendour and decadence and for good measure chucked in the vices of greed, lust, envy, bestiality, gluttony and sarcasm.

Fortunately, just before I was spirited away to poverty-stricken Ireland, a good fairy turned up.

Unfortunately she was late (as apparently Cinderella had needed emergency contraception and didn't realise she could buy it OTC), and she couldn't restore me to my rightful place among the royalty of Europe, nor did she have any other decent presents handy. The only gift she had left to bestow upon me was sloth, which she reckoned would protect me from the worst excesses of the other vices, all of which need a bit of energy. 'Thanks for nothing lady,' I might have said, 'Sod off back to your gingerbread cottage.'

This explains why I have always been seriously lazy, and why I chose general practice out of a sense of vocation. Dressing in tweeds, smoking a pipe, walking a dog, sitting back in a comfortable chair listening to people drone on and on, occasionally tootling down country lanes; it was the perfect career for me.

But not any more, because we are getting busier and busier all the time and it's only partly due to the vast and ever-growing bureaucracy trying to drown us.

Most of it is due to the inexorable advance of scientific knowledge. However long it takes to percolate down from the ivory towers to the grass roots, it inevitably means more work.

Fifteen years ago, patients with AF were put on digoxin and that was the end of it. Now they need warfarin, with all the associated supervision it requires. In the same way, every few years sees another vaccination come along, a new screening programme introduced.

And with every advance, it's not as if something drops off the back of the bus that we can stop doing. We can't stop seeing kids with URTIs or stop treating hypertension. Varicose veins and hernias still need to be referred, cardiac risk factors still need to be modified. The workload is ever expanding, the demands ever increasing, the expectations on an ever-upwards spiral.

I expressed my frustrations to my Auntie Mamie.

'C'est la vie, votre Majeste,' she said.

Dr Farrell is a GP from County Armagh.

Email him at GPcolumnists@haymarket.com.

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