Choose me to be your GP!

I’ve noticed that the advocates of healthcare markets are very keen that patients ought to be free to choose their GP, so I’ve written an advert to help them choose:

I am a GP partner in a 5 partner, state of the art health centre in central London. I am passionate about family medicine and personal care and I see it as my duty to provide the highest quality medical care from maternal and child health to palliative home care. I work with a highly professional team of partners and associates to provide a fully comprehensive primary care service. I have excellent working relationships with the very best hospital specialists and we pride ourselves in our team work so that you have the best possible integrated care whenever necessary.  I have special interests in musculo-skeletal medicine and neurology and I am an honorary lecturer and teach clinical skills to GPs and medical students.

Did I convince you?

Did you notice I said absolutely nothing about how I compare with other GPs on quality, productivity or efficiency? There’s no way of measuring these things, so I couldn’t tell you even if you asked. So if you were hoping to use market forces to drive up quality, you might run into some problems.

One thing I’ve noticed is that whenever someone is claiming that ‘people’ ought to be free, what they usually mean is that ‘they, personally’ ought to be free. They are not usually thinking about the alcoholic, drug-addicted, homeless, schizophrenic, diabetic amputee directing the traffic from their wheelchair. (He’s my patient)

Most of my ‘regular patients’ are not very choosey. They are elderly, illiterate, anxious, depressed, disabled, sick and in need of care. But they are not very good at choosing. They are not, on the whole, inclined to look online for reviews and consumer forums before buying a new iron or opening a bank account. In fact very few people change bank account even when they are dissatisfied with the one they have.

The problem with you, literate reader, choosing me, competent GP, is that because I can only provide a comprehensive service to a limited number of patients, the more of you that choose me, the less room there will be on my list for patients who really need me.

This is the Inverse Care Law.

As Marx (Groucho) might have said,

“I would refuse to register any patient who would choose me as their doctor”

Post script.

I do believe that patient choice is at the core of humane, patient-centred medicine. Every consultation I have with every patient involves careful discussions about important choices. I’ve written a lot about it. You could start here: The choices patients make.

5 responses to “Choose me to be your GP!

  1. You’d have to offer a lot of Fortnum & Mason vouchers to get my business.

    Personally speaking, I stay as far away from GPs as possible – even if they are state of the art. I certainly don’t want them in charge of my tax revenue.

    In 37 years of adulthood, I can only recall 2 GPs who have been of any help to me, and they were newly qualified transients who moved on quickly to better places.

    “Integrated care” is not in any GP dictionary I’ve ever read and #nhsreform won’t magically make it happen.

  2. I was suspicious as soon as I read the word ‘passionate’ !
    Joking apart you point out something which had not occurred to me – the rise of the ‘oversubscribed GP.

  3. Consider my requirements as a taxpayer (paying customer iow)
    Your access times are important to me – can I see you at 21:00? Or 6 in the morning? I too am self-employed these are the hours that suit me
    Can I book online and will you give me your mobile number for a telephone consultation if needed?
    Will you engage in a dialogue when I see you or will you google my symptoms (I have already done that) or will you dismiss my input? What are your views on ‘our relationship’? Can we engage on the use of statins or will you fall off your chair when I mention this?
    Will your practice staff offer me choice and not take umbrage when they realise I know more about Choose and Book than they do?
    How do you keep yourself current and up to date and what was the last CPD you did?
    When last did you renovate your surgery and what future plans do you have to upgrade premises and IT?
    Why have you not offered me a health check and why do you get angry when I ask about this?
    What would you do if you order diagnostics that I know aren’t necessary and i challenge you on this?
    Please provide a copy of our annual accounts.
    And if you successfully meet my standards, I will choose you as a GP. In return I will promise not to worry you unnecessarily, comply with prescriptions you give me, lose weight and monitor my blood pressure

    This is what I want from my GP. The question is do I get it? And can I please have the freedom to chose any GP anywhere, Mr Cameron?

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