Paul Lord: Too many “tick box” exercises

paul_lord“L’enfer, c’est les autres”—Hell is others

As I progress from trainee to GP, I have taken time to reflect on the process I have been through and I think this saying sums it up. No, I’m not an antisocial existentialist (nor did Sartre intend that the line be interpreted that way), but I have found my existence reduced to the sum of the judgements of others.

Sartre’s Hell was the lack of ability to see yourself, lack of self-judgement, and subsequently self-worth. It was relying on the opinions of others to define and validate yourself.

Yes, I have spent the last few years trying to develop into the best GP I can be, but I have spent as much time making sure that I appear to be the best GP I can be. Did one more DOPs or CbD assessment improve the health and wellbeing of my patients? In an ironically reductionist way I have spent a lot of time this year ensuring I have ticked all the boxes that prove I can practise holistically.

I look at job adverts at the back of The BMJ and they have started to merge into a homogenous list of attributes, a checklist of things: High QOF achievement, patient survey results, “Good” rating from CQC…

Too commonly I hear that general practice is becoming a “box-ticking exercise,” and we have ourselves to answer for this. The ePortfolio, CQC, QOF, DES, appraisal, and revalidation; we invite external assessment to be our mirror and validate our existence without recognising the damage it could be doing to our self.

So what is my Heaven—I’m not sure. Perhaps it’s a nice team of people, a consulting room with a plant, and maybe even carpets. Perhaps it’s an opportunity to develop for myself, to be my own judge, my own mirror. Anyway, I continue to browse the job adverts…

Paul Lord is a GP trainee based in Bradford, West Yorkshire, and an Academic Clinical Fellow at the University of Leeds.

Competing interests: None declared.