To this comedian, GPs are a joke

But why should we care so much what Hamish Blake thinks?

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I woke on a Saturday morning to a tweet from Dr Mariam Tokhi, stating her disappointment at Hamish Blake for minimising the job that GPs do.

Everyone thinks could be a GP. Even father of the year @hamishblake reckons it’d be a walk in the park: just coughs, colds and referrals.

Happy to have you sit in my room and give it a go?

I’m tired of privileged folks thinking their experience of health system is it.

— Dr Mariam Tokhi (@mariamtokhi) October 6, 2023

As the day wore on, more and more people, GPs and non-GPs, started chiming in on the importance of primary care being far more than just “colds and referrals”.

Several colleagues messaged me their fury, so much so I asked for a link to the offending dialogue on their latest podcast episode (#232) and listened to the five-minute segment.

The premise?

Q: What’s the highest job you qualify for with your current skillset, that you could turn up and competently put in a day of work at?

Blake said “With the greatest respect … I’m not shitting on GPs”, and then went to do just that for the next five minutes.

What’s his thinking? “I have enough general medical knowledge, colds and what not – that’s what the day is! … They Google all the time!”

While disappointing, it was not surprising, because we know this is what the general public and media thinks of us and our job, including many of our non-GP colleagues.

To my surprise when I listened, I was also … amused rather than furious. On the surface I can see why, especially to a privileged, healthy person with the means to pay for top-level care, this would be the bulk of the reasons you’d access a GP: a cold, a medical certificate, referral to see a “real” doctor, vaccination (which the nurse does), etc.

No wonder there’s been this push and support to allow pharmacists to prescribe medication, if this is all the public thinks we do!

What was interesting to me instead was the degree of anger among my colleagues. All day into the evening, my feed was filled with GPs detailing their day – “only saw one cold and one referral but did have (long list of complex medical conditions)” – and invitations for Blake to sit in their rooms for a day.

I’m mostly sad to see that this is what the public thinks of us. I’m equally sad to see the anger and even despair it has created in many of my colleagues who work with severely disadvantaged communities and groups for a pittance and would be grateful for the occasional “just a cold” or “just a script” or “just a referral” consultation.

I get the anger. I feel frustration every week when I come across a patient who asks me to give them a referral, or to order pathology for them, or write a script to bypass finding a GP because “they’re all crap” to which I regularly say “I’m a GP” and get “No, you’re not.”

Except I very much am. And proud to be one.

Occasionally, depending on the level of need, I bend my rules and do the script or write the pathology form and urge them to keep looking till they find a GP. Like psychologists, fit is important because this person is going to be your longterm partner in your healthcare, so it makes sense that some effort needs to be put into it and it’s a numbers game.

I get why someone like Blake might think the way he does because it is the way the vast majority of the privileged wealthy public thinks. They have the means to pay for their care, likely enjoy good health and believe their Google search is equivalent to if not better than the care a GP can provide.

Why are we so affected by the uneducated opinion of a 41-year-old radio host who is so shielded from the reality of general practice that he truly believes his supposed “general medical knowledge” is equivalent to a minimum of 11 years’ full-time study and work?

When we have been in struggletown a while, it can become easy to feel like we will never see the light at the end. If we surround ourselves with people who only echo our rage and despair, we risk sitting on our pitypot endlessly. By all means be angry, correct the assumptions and then continue to do the excellent work we do. Change is hard, which is why most of us resist it.

To me, the degree of anger this has elicited is more a sign that we, as a collective, need to work on why the opinions of people who don’t know us bother us so much.

Medicine is a conservative industry. It requires among the longest degree of study and work to qualify and then to specialise in the prime decades of our lives. We are mostly hardworking people. Many of us come from privilege but some of us don’t. All of us want to be liked, to be respected and to feel like the work we do is meaningful and makes a difference.

We are also, I’ve long suspected, inherently people who have never been taught effective boundaries, nor any basic skills around money, or business. Most of us hate talking money. And barring legal reasons to say no we don’t like disappointing other people.

It’s a perfect storm of burnout, anger and disappointment, then, when the hard work we do goes unrecognised, especially if we do it while running on fumes and at a loss to ourselves.

But that is an “us” problem. A healthy sense of self and awareness of the real change we make would leave us reading this one person’s opinion as just that – an opinion – even if he has a wide following.

We would do well to pull him up on it nicely, but at the end of the day, if we didn’t rely on others to give us our sense of self-worth and the work we do, I don’t think it would bother us as much as it seems to have done.

No doubt people will write about what their job entails, how wrong Blake is, and the privilege of not needing to see a GP for much, or to be able to pay at least twice as much to see a “real doctor”, but this was my biggest takeaway.

Other people don’t inform our self-esteem if it is healthy and intact; we do. The fact that so many of us were left fuming for much of the day is again indicative of the change that needs to come to general practice to make it great again. And that is an inside job.

THURSDAY UPDATE:

Kudos to @hamishandandy for their apology to GPs on their podcast this morning! We'd be happy to have you visit Utopia Refugee Health any day, and come see the work we do in a suburban GP clinic.

Thanks for keeping us laughing, especially when our work feels heavy.

— Dr Mariam Tokhi (@mariamtokhi) October 12, 2023

Dr Imaan Joshi is a Sydney GP; she tweets @imaanjoshi.