The Easiest Specialty to Do Poorly

The thing about General Practice, is that it’s probably the easiest speciality to get away with doing poorly. (Read that twice if you need to). It also happens to be the hardest one to do well. And, to compound this frustrating situation which tarnishes our reputation, GP care is remunerated far better for being fast than it is for being any good. Thus, the clinician who is being thorough and compassionate, teasing out the underlying issue, having tough conversations (eg antibiotics and opioids) and offering evidence-based alternatives instead of simply prescribing inappropriately (definitely a time-saving approach) is punished for their efforts. They will attract increasingly more complex patients, with a diminishing ability to pay a gap fee, while their colleague who is “quick” manages to keep everyone happy! Often, our patients are not actually in a position to accurately evaluate the treatment they receive. Manner and engagement, yes, but when they decide if their doctor is “good” or not based on whether or not they walked out with what they wanted, the measuring stick is wildly inaccurate. I pride myself on providing great care – and my patients would agree. But it is slowly killing me. It’s heartbreaking to know that if I cared less and neglected more, I’d make easily twice as much money and maybe cry less in the car on my way home.

But the thing is, I can’t switch off that part of me that cares. And I don’t actually want to.

What I would like is for it to be recognised, and positively reinforced by the government’s rebates instead of simply being taken advantage of while my patients and I suffer.