Based on your experience, what would you say are the main challenges of being a physician (and a GP in particular) in the UK at the moment?
I think it’s the workload, in particular the amount of work we need to do in such a short time frame. It’s the 10 minutes consultations, the emergencies, the demands and expectations. There is also a lot of admin work that GPs specifically need to do that wasn’t there before, and unfortunately it takes up a lot of our time.
In addition, a lot of the work that used to be done in secondary care has now moved down to primary care. This might include things like looking after rheumatology patients or patients who are on ADHD.
Do you see this situation changing and can you think of any solutions?
I think the situation is exploding. A lot of people are running away from it, a few are still there, hoping that it’s going to subside, but the reality is that it’s not going to.
I think the only solution would be to either have extra funding, which I think is going to be impossible, or to charge patients for use of service.
Technology can also be a solution, with Skype consultations and means of doing things more online rather than face to face. However, that is more to make best use of doctors’ time, and in fact I think that it compromises care and it’s not in anybody’s best interest.
Despite the difficult situations we have just discussed, what would you say are the upsides of being a physician in the UK? What makes you go to work every day and enjoy what you do?
Today there are more treatment options, more testing that can be done, more ability to combine different drugs. There’s a big workforce of people who are forward thinking and doing the job for the right reasons. So I feel empowered by the people I work with and still get pleasure from making somebody feel better.
You have participated in several market research studies with M3 Global Research since you became a member of our panel in 2011. What would you say are your main reasons for still participating today?
If an incentive is being offered that is one reason, of course. Also, I usually find the topics interesting and enjoy feeling that I’m at the cutting edge of what’s new and what’s changing. It’s exciting to talk about dilemmas in prescribing and to compare and contrast the benefits of different drugs of the same class. I like it when I meet with a group of other GPs – there’s one group in particular that includes hospital specialists as well as GPs –, and we debate and compare our notes.
Do you feel like your participation in these studies can somehow eventually improve healthcare?
Yes, I think we know well what the barriers are for treating our patients, and what they need. Since us GPs are a good source of information, when I do market research I feel like I can bring that into a discussion or a one to one conversation. When I’m doing an online survey, I am able to rate and rank taking into account some of the complexities of the patients I deal with.
By sharing our respective knowledge in a group activity I think we can identify defined needs and then consider what sort of therapy is needed to have improved risk reduction of diseases and to look at what patients actually want. We have quite good background knowledge as generalists so I think listening to our views stops medicine and healthcare going in the wrong direction.
You already mentioned that you see market research as a chance to discuss topics with colleagues and compare notes. In your daily work, do you feel like the topics of the surveys are valid topics of discussion with your colleagues?
Yes, as I mentioned before the group activities, particularly when there are doctors from other specialties attending, are a very good opportunity to see how prescribing can vary at a local or regional level. When I get back I think ‘well, I heard about that from a specialist’, so it makes me sometimes review how I do things, and I’m more likely to be able to make some changes. I learn a lot and I, too, can express to a specialist my work and role as a GP which I’m sure informs their practise. Sometimes we become a bit separate, the GPs and the specialists, so I find that these meetings are quite good to integrate us again.
How do you see the use of technology resources such as health apps, online consultations, and smartphones developing as diagnostic tools for doctors in the UK?
I think they are taking off and potentially taking over. Patients like to communicate with the GP via telephone and Skype, for example, because that benefits the patients in terms of time and effort. But from a GP’s point of view, we miss a lot of cues. These cues can be very subtle: a blink, a twitch, a flicker, a smell, a pause, these sort of things are so fundamental.
Also, although I feel that some technology is very useful, particularly for diagnosis or by giving patients the ability to monitor their blood pressure, check their glucose levels etc, we are not able to make full use of them. Currently I wouldn’t have time to look at data that I receive by email from a patient. We already have lots of sources of information, so we would become quite easily overloaded with all the information given to us by patients.
On the other hand, when patients show me their blood pressure results, BMI statistics and exercise diaries, I can see how engaged and empowered they are and how technology is being very helpful. In conclusion, I believe that for some patients it’s been very helpful. Regarding the consultations by Skype and telephone, I think there’s a bit missing.
What you believe will be the main challenges for doctors in the immediate and distant futures?
I believe that medical training is a bit outdated now. It should be more technology and test driven, with less on the examination skills. In the future, probably what will happen is that doctors will become more like technicians and perhaps some of the work will be robot driven. Symptoms will be typed in and a printout of what tests should be done and a summary of what the diagnosis will be will come out. Then the examination and investigation components will eventually be replaced.
Another issue will be home visits. We have an aging population, with more patients living alone without support. The visits can already be very time consuming, with traffic being so terrible. Maybe a solution will be dividing the work, and having different roles for each GP.