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Vishal Gulati

We May Not Need the 5000 GPs That We Think We Need

April 4, 2016

Harnessing the power of a range of clinicians will require a clear understanding of how appointments are currently conducted, and how clinicians might be trained to take on new roles. Larger practices, as shown by international leaders such as Southcentral in Alaska, which has redesigned its workforce to more efficiently address the needs of its 60,000 patients, will also be better placed to reshape their workforces. The implications and practicalities of these changes for the NHS will be outlined in a forthcoming Reform report on the future of general practice.

Source: No more GPs? No problem | Reform

The greatest paradox of UK primary care is this. When it comes UK’s GPs, their biggest complaint is how busy they are and how trivial the complaints of patients who ‘overuse’ their services and don’t value them. If you believe the data on number of patients using general practice you have some sympathy with it. But curiously enough the only solution they are willing to entertain is to have more GPs join what they describe as a job which is driving them to despair.

UK GPs are some of the best trained in the world and primary care general ‘specialist’ is an institution which has been mastered in Britain like nowhere else. It takes ~10 years of post high school training to become one. So the question is this, if most of the patients who come to see a GP are beneath the skill set of the physician why do they want to keep seeing more and more of them?

Surely, a sensible approach would be to:

  • triage patient load (dare I say, using digital tools, algorithms, machine learning, humans)
  • staff surgeries with a mix of clinical professionals – complaints which can be dealt with by nurses or pharmacists should be passed to them
  • make surgeries bigger so they can load balance better

What if we found out that there was was a country where university professors were being made to teach primary school students and because the number of students in primary schools was rising, that country was going to spend its resources training more university professors. You would think they were mad.

I will let you draw your own conclusion about the sanity of our approach.