{"id":34772,"date":"2015-07-21T10:44:44","date_gmt":"2015-07-21T09:44:44","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=34772"},"modified":"2015-07-21T10:44:44","modified_gmt":"2015-07-21T09:44:44","slug":"paul-lord-too-many-tick-box-exercises","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2015\/07\/21\/paul-lord-too-many-tick-box-exercises\/","title":{"rendered":"Paul Lord: Too many “tick box” exercises"},"content":{"rendered":"

\"paul_lord\"<\/a>\u201cL\u2019enfer, c\u2019est les autres\u201d\u2014Hell is others<\/em><\/p>\n

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.<\/p>\n

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.<\/p>\n

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.<\/p>\n

I look at job adverts at the back of The BMJ<\/em> 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…<\/p>\n

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.<\/p>\n

So what is my Heaven\u2014I’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…<\/p>\n

Paul Lord<\/strong> is a GP trainee based in Bradford, West Yorkshire, and an Academic Clinical Fellow at the University of Leeds.<\/em><\/p>\n

Competing interests:<\/strong> None declared.<\/p>\n