I’m determined to be a joyful GP in 2023, and that means breaking up with patients who destroy my day.
Welcome to the new year. The year of the rabbit.
Even though January doesn’t really represent anything new in terms of a different house, place of practice or job there is always a sense of a new beginning, don’t you think?
And while I may make fewer new year’s resolutions these days (years of seeing them go by the wayside by March will do that) – I am a pathological list maker. And at this time of the year – such a list takes the form of goals I’d like to achieve in 2023.
In terms of general practice, my main aim is to rediscover the joy and satisfaction that should be inherent in the nature of what we, as GPs do for a living.
That sounds a bit twee I know but let’s face it, last year was a bit tough for Australian GPs. You would have to be made of much sterner stuff than me not to have developed something of a siege mentality by the time Christmas came …
… between not-so-subtle allegations that we were somehow ripping Medicare off to the tune of billions of dollars to new onerous and punitive annual CPD requirements starting this year to pharmacists being granted prescribing rights without even a nod to the concerns of patient safety and conflict of interest … it was not a happy year.
Added to this, patients seem to be demanding more and more for less and less – my perception I know but surveys suggest I’m not the only one experiencing this. You would think this might just be a consequence of privately billing – people wanting to get maximum bang for their buck, but even my bulk-billed patients are coming in with more issues, more paperwork, more requests and all to be done in a 15-minute appointment. Of course, online booking systems haven’t helped – patients notoriously underestimate the time they require.
And the other increasingly time-consuming role I seemed to have inadvertently taken on is trying to find the suitable specialist or allied health professional for a particular patient. One who is willing and available to see my patient in a reasonable time frame. Aaaaarrgghhh!
But this is what I need to change. I can’t control what outrageous headlines hit the newspaper. I can’t control the deals made between the pharmacy guild and the government. And I have little option to do anything about the CPD changes.
But I can control my appointment book and schedule in more catch up times. I can put the onus back on the patient to do the ringing around – I can recommend three or four names and then they can do the legwork. It means I write the referral letter later but that’s nothing in the scheme of things.
The other biggie, that I suspect will help restore my enthusiasm for my general practice– is – for the first time in my life – I’m going to divorce a couple of my particularly difficult patients. Not difficult medically – no – it’s a personality issue.
You know the type – manipulators of the system, wanting referrals, tests, exemptions and services that, in my opinion, aren’t warranted, convinced they know their problems (courtesy of Google or their naturopath) and completely ignoring any advice I offer. They obviously have little if any regard for my medical expertise – I am just a useful, Medicare-rebateable means to an end.
It’s crazy, isn’t it? These are just a couple of individuals among dozens of perfectly lovely other patients, and yet, having either one in a session just wrecks my day. I have many more patients that are medically challenging but even though they too will keep me awake at night they are not nearly as emotionally draining.
The plan is: next time they book I will ring and explain it is in their interest to see another GP as I no longer feel able to treat them. I hate conflict, so I hope they just leave it at that, but if they push – well, that is what it has been recommended I say (yes – I did ask advice).
Even just having made this decision I have felt a weight lift of my shoulders.
It is probably a combination of a lot of factors including my age, but I did have that sense of being ground down at the end of last year. A feeling of powerlessness as I became increasingly disaffected with my chosen profession. Younger GPs are perhaps a little more resilient, but I know of many GPs who have been feeling the same.
The answer, at least in part, has to include regaining control. Even if it’s only regaining control of who I see and when. It remains to be seen how effective my upcoming ‘divorces’ will be in restoring my enthusiasm, but I am hopeful, and, as I say, already there is a sense of liberation.
No doubt, 2023 will have its own unique challenges. Already the head of the Pharmacy Guild, Trent Twomey’s comments have sparked justifiable outrage among the specialty. Twits indeed!
Nonetheless, I am determined to face the year with optimism. I am going to do what I can to minimise the frustrations, exasperations and annoyances that create misery in clinical practice (apologies in advance to whoever picks up these “divorced” patients) – and hopefully the year of the bunny will prove more rewarding and satisfying than last year. Fingers crossed and happy new year.
