Viewpoint: Why I'm Choosing General Practice: Khalid Khan

The landscape of general practice is undergoing a transformation due to the modern challenges of healthcare in the 21st century.

Khalid Khan: 'I believe no clinical setting provides as personal and intimate an encounter.'
Khalid Khan: 'I believe no clinical setting provides as personal and intimate an encounter.'

Specifically, there is growing demand for GP services owing to the demographic changes of our society and the resulting complexity of patients who increasingly present with multiple long term illnesses. This is against a backdrop of an NHS funding freeze, and moreover, disproportionate funding for general practice. These challenges notwithstanding, I believe there are compelling reasons for choosing general practice.

In relation to the above, flat funding and disproportionate investment of funds in general practice are issues that reflect the public spending policies of our current government. Nonetheless, all governments are transitory and, by extension, these policies subject to change.

I am reluctant to let political issues dictate a career decision 

I believe it would prove difficult for any responsible government not to make the NHS their priority in their public spending. The same applies regarding the proportion of NHS resources spent on general practice as the NHS will not be sustainable without it at its core. I am therefore reluctant to let political issues dictate a career decision with far longer lasting consequences.

Regarding the growing demand, this is a modern problem due to the demographic changes in our society, but it is certainly not confined to general practice. The NHS as a whole is susceptible to the impact of our growing and ageing population, not to mention patients with multiple co-morbidities. To illustrate this, elderly patients, who frequently have complex medical histories, are already the most intensive users of hospital care, and this will only increase with the ageing population.

Abundant variety of patients and their clinical presentations

Ultimately, I am choosing general practice based on the nature of the job itself. For instance, one of its most appealing aspects to me is the abundant variety of patients and their clinical presentations, which makes each encounter a different experience. This was evident throughout my GP placement, but the first day particularly comes to mind for beautifully illustrating just how contrasting an experience each consultation can be. That morning, the GP was presented with a three-month-old infant brought in by her mother followed by a consultation with an elderly blind patient – two contrasting consultations with very different dynamics. It is variety like this throughout the day that keeps the job interesting. Whilst most hospital doctors generally deal with a more defined patient group presenting with typical complaints, there really is no such thing as a ‘typical’ patient in general practice due to the broad nature of generalism.

More compellingly, however, I believe no clinical setting provides as personal and intimate an encounter over as extended a period of a patient’s life as general practice. I find the prospect of witnessing a whole journey unfold before me and the rare privilege of being invited on such a personal journey awe-inspiring. This cannot be replicated to the same effect in a hospital setting, where patient contacts are much briefer, and it is particularly for such patient interaction that I applied for medicine after a background in medical science.

  • Khalid Khan is a student at Nottingham University.

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