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Tauseef Mehrali on the universal strategy

13 Oct, 08 | by BMJ Group

Tauseef Mahrali With the month of fasting behind me and afternoon blood sugar levels now soaring above 3mmol/l, I’m really quite getting into the swing of general practice. It’s the Russian roulette of the medical world. Your fate is simultaneously within and way beyond your control. After all, it was you that called that patient in during the emergency surgery.

A staggering amount of risk-management takes place in primary care. How long should you hold on to that puzzling patient who conveniently falls between NICE guidelines? The tale of the Brazilian nominee for a Darwin Award in 2002 is a succinct lesson in the potential consequences of not letting go.

I broke from a lifetime’s tradition of celebrating Eid with family and instead celebrated Eid this year with my new surrogate family, the Royal College of General Practitioners, at their second annual conference in Bournemouth. I had two aims on signing up to attend: to present a poster and to see Lord Darzi receive a mauling at the hands of the nation’s GPs. Lord Darzi bottled it and did nothing to dispel the notion that his existence is now perhaps more difficult to prove than that of God. Some would say that the two have never been seen in the same room together.

However, Fergus Walsh, the BBC’s medical correspondent and chair for the conference kept us entertained. One particular anecdote caught my attention. He described a crash course in questioning imparted to him by John Sergeant which I feel could form the basis of a revolutionary new 10-minute patient-led consultation model.

Question 1: How bad is it?
Question 2: How bad is it going to get?
Question 3: What can be done about it?

Mingling and sharing experiences with other delegates and trainees from around the country and abroad was invigorating. The fears of fellow GP registrars at the genuine prospect of unemployment were palpable though. My illustrious predecessor at the practice, Rachel Tait, captures the undercurrent of anger and dissatisfaction in her ‘Recipe for success?’. The shambolic planning of GP workforce needs is very real. I know of too many colleagues who, having successfully completed their GP training, are now running the locum labyrinth or have sacrificed their NHS pensions to work in salaried McJobs. The government’s answer? The universal strategy of course. When there’s a credit crunch, flood the markets with money. Lots of money. When there’s a crisis in GP employment, flood the market with GP trainees. Lots of GP trainees. 600 more in London by 2011 to be precise.

Tauseef Mehrali is a GP registrar

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