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03-07-2011 | Article

GPs cannot win

GPs are used to a constant stream of either criticism or outright attack. In fact, we are so used to being at the receiving end of this ongoing disapproval that sometimes we don't take it in. Certainly after the last GP contract came into force, we were at the receiving end of a fairly sustained media campaign that centred around being overpaid.

According to the BMA chair, GPs are still under "a drip feed of media attacks", as reported by the univadis GP News service (click here). On the clinical front, there seems to be an ongoing stream of messages that GPs could do better in almost every activity we do.

Of course we should always be aiming to up our game and improve our output, but incessant criticism means that we develop a thick skin and potentially become less reactive to change. How often do you see articles stating that GPs are doing a good job, compared with ones saying we do a bad job? My gut feeling is that the number of the latter is far greater than that of the former. Part of the reason may stem from the description of a GP I remember being given when I was a medical student - that of a "jack of all trades, master of none". That modern source of human knowledge, Wikipedia (click here), defines this phrase as "a figure of speech used in reference to a person that is competent with many skills but is not necessarily outstanding in any particular one." I would argue that is an unfair assessment of a GP.

Interestingly, two recent articles published in the univadis GP News service fit with my argument. One article indicated that there is room to improve GPs' prescribing (click here). The other was headlined "GPs struggle with dementia diagnoses" (click here).

Sure, we can strive to be better, but as GPs are by definition generalists, we will never excel at every aspect of the huge and diverse number of clinical and managerial tasks that we have to face every day. Yet that seems to make us an easy target for criticism, particularly with medical complexity increasing at an enormous rate.

We need more facilities, easier access to specialist services and imaging and more time to spend with patients. But even these luxuries will still not allow us to excel at absolutely everything. It will help to improve the service that we offer to our patients, but I fear that may not stop the criticism that seems to be part and parcel of the job.

Best wishes,


Dr Harry Brown, editor-in-chief univadis

By Dr Harry Brown