Liam Farrell: Trying to do too much will prevent us doing anything at all

There's not enough hours in the day to do everything - even research says so, writes Liam Farrell.

According to research (for which I could list the references if required, even if no-one ever bothers to ask, although references are like nice wallpaper, or having Emeritus before your name, they always add a bit of tone, a bit of scientific gravitas, don't you think?), if we reckon on 15 minutes per consultation, a family doctor with 2,500 patients would spend 7.4 hours per day to deliver all recommended preventive care and 10.6 hours per day to deliver all recommended chronic care.

This leaves a generous six hours every day for that pesky acute care, looking after the worried well, sick certs, sick kids, paperwork, eating, sleeping, banging our heads against the wall in sheer frustration, toileting and reproducing.

The truth is, you can get a lot done when you don't have, you know, a life.

And even our six hours of freedom are under threat; no research paper worth it’s salt can ever finish without the words ‘GPs should…’. The ‘recommended’ care by outside experts with zero understanding of the realities of primary care continues to pile up, like Pelion upon Ossa.

Yet we continue to accept it, like Boxer in Animal Farm, we put our shoulders to the plough and resolve to work harder; it’s not our nature to complain, to say no.

Come in and put your feet up, we say instead, and bring your recommendation with you, we have a nice spot for it beside the hearth. When you want something done, ask a busy doc.

But it’s time to say stop, we can’t do this any more, it’s too much. It may seem like we are raising the white flag of surrender, but as Rincewind said: ‘Lots of people would be as cowardly as me if they were brave enough.’ Trying to do too much will prevent us doing anything at all.

There is a wonderful German word: verschlimmbessern, which means 'to make something worse by trying to improve it’. By striving to make general practice ever better, we are making it an impossible task.

‘If we want things to stay as they are,’ said Tancredi, ‘things will have to change’ and, as in so many things, from writing columns to having sex to being a family doctor, perfect is the enemy of good.

  • Dr Farrell is a GP from County Armagh. Follow him on Twitter @drlfarrell

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