2 weeks in GpLand.

The past 2 weeks in GPLand has been torture. Having to sit through baby immunizations, hypertension checks and asthma reviews is painful. And compounded onto it, my GPLand fellow sufferer and I feel like intruders in this place, not to mention that we have gone through half our posting without having met our supervisor at all. Brilliant, and this is supposed to be the posting that consolidates our learning in primary care.

Sitting in GP consultations like this makes me extremely frustrated for a multitude of reasons-

1. Im not learning much for finals/ for life as a junior doctor. Very self- centered reason, but really, doctors should not agree to take on students if they dislike teaching. Also, having 2 students in the same consultation room, taking turns to clerk pts and present is highly inefficient.

2. The GP here only sees about 6h of patients each day (3h in the morning and 3h in the evening). This probably makes us doctors less hardworking than the average office worker who works 8h/day. 2h lunch breaks are too long (1h is more than sufficient), and more doctors (and nurses) should be seeing patients till late- in my opinion 10pm ideally (so that working people dont have to take time out to see the doctor for routine stuff). Shift work can be arranged if necessary (ie. If doctors arent prepared to work too long hours), so doctors work the same number of hours but the surgery is open for longer. And clinics should be open during weekends! I dont think we were really made to NOT fall sick on weekends at all.

3. Basic investigations such as blood tests and ECGs should be available at GP clinics (its almost ridiculous that pts travel down to the hosp just for a ECG). Ideally, there should be an onsite phleb/ nurse to do this throughout the whole day. This will defo save the NHS loads of resources and poor elderly pts the trouble to travel all the way down to the hospital.

4. GPs are meant to manage the pt holistically and to know their pts really well. In reality, not at all the case- pts see a different doctor each time, have only 10mins so can only discuss 1 issue at a time: he cannot have back pain, poor diabetes control, depression and urinary symptoms at the same time. This will probably take him 4-8wks to sort out all issues.

During times like this, I feel like Im ready to move home. Im afterall brought up the asian way- kancheong and being efficient is important +++. I just hope, I wont ever lose the idealism I have for medicine.