DAUK co-chairwoman and GP Dr Ellen Welch wrote in The Times to call for ending the bashing of remote GPs.
“Various newspapers reported with horror this week the case of a GP working remotely for a practice in Surrey, whilst living over 200 hundred miles away in Cornwall. The comments sections were alight with outrage as keyboard warriors indulged in what has become something of a national sport of late – GP bashing.
The sad irony in all of these articles is that general practice is elbow-deep in a recruitment and retention crisis. We have 1,896 fewer full time GPs than we did in 2015 and we’ve lost 389 this year alone. The obsession with face-to-face appointments from some sections of the media is losing sight of the fact that an experienced remote GP is better than no GP at all.
I’m a remote GP, and I haven’t seen a patient face-to-face since 2019.
I still feel pangs of guilt saying this, despite the fact I manage to clock up between six and eight sessions a week remotely. In each four hour session I have 24 patients booked – that’s 48 a day – almost double the number of patient contacts the BMA advises is reasonable per day. If someone needs an examination, then I can arrange this with a colleague easily. Patients I consult with are often speaking to me the same day they raise their problem, and many have solutions provided without leaving the comfort of their own homes. The time I spend staring at a screen is increasingly stretched beyond my contracted hours and the work/home boundaries blur as I fit admin in after my children’s bedtime.
I’m not unique. Working remotely in any other sector would barely raise an eyebrow. It’s a choice I have made, like a million other working mums, to salvage the time spent commuting; to be able to earn if my children get sick and I have no childcare, to enable the juggle. It allowed me to return to NHS work within weeks of having both my children, which I just wouldn’t have done otherwise. It’s something I simultaneously regard as a privilege, that I could do so, and a curse that I didn’t have longer simply being a new mum.
However as a GP, the rules are somehow different. We have a romantic notion of general practice, and the go to image is of a kindly old man with a Gladstone bag, cheerfully popping in for a home visit with his patients at any time of day or night. The sense of vocation associated with being a GP has sadly been corroded and in 2022, doctors are qualifying with debts stretching to six figures, threats to pay and pension, and working conditions that are impacting on our mental health. Workload in general practice is unrecognisable from even ten years ago when I started out. GPs are consulting with more patients than ever before. We’re handling the backlog of care from the pandemic and often dealing with patients unable to access secondary care. Remote medicine can be transactional, but it allows efficiency, and it provides a safety valve to take some of the pressure off a system at breaking point. The reality that the headlines also ignore is that many patients also prefer it.
Telemedicine is huge elsewhere in the world and countries such as Australia have embraced it to provide care to remote areas. Even in the UK, specialties such as radiology have utilised it for years, often employing doctors based overseas to help with their workload. It’s convenient, it’s safe when done well, and it allows those in hard-to-recruit areas to gain access to a doctor they would have otherwise gone without. We also forget that remote consulting was mandated by the government in 2020. GPs have been ravaged by the press and by patients ever since — with our leaders only too happy for us to shoulder this blame.
As GP numbers continue to plummet, those of us who haven’t left for Australia or the private sector are increasingly burning out. Abuse towards NHS staff is commonplace. The number of doctors dying by suicide is on the rise. The recent death of hardworking GP Dr Gail Milligan was attributed directly to her overwhelming workload. Whatever your opinion is on remote working, the simple maths tells us we don’t have enough GPs right now. We need to move away from this negative narrative around GPs and applaud creative solutions to bolster the workforce.
Dr Ellen Welch is a GP in Cumbria and co-chairwoman of the Doctors’ Association UK”
Read the full article here.
