Wednesday, January 21, 2015

Having...fun

Seven. I did a quick headcount as I sat down. There were seven GPs in the room. The there were GP trainees, the practice nurses, the practice manager, the community diabetes specialist nurse and finally me. It was the regulation biannual visit to one of our local surgeries..Swan surgery in Petersfield to be precise...as part of our diabetes model of care. And tell you what? A few hours whizzed by.

It was actually fun..and those hours had everything, chat about patients in whom everything else had been tried, discussion about evidence of new drugs, chatter about the condition of pre-diabetes, review of an audit, talk about the difference between type 1 and type 2 diabetes, suitability for an insulin pump, the services available...and you know what? I go back to again the same word...it was actually fun. There was light hearted banter amongst all, there was a GP amongst them who worked for the local CCG who took a few jokes on the chin, we joked about how who was the busiest..and we did so over lunch..we talked about patients, we talked about improving care, we talked about the next steps...and in case you missed it...Yep, it was fun.

Why do I share this with you? Simply to also give you a perspective that not all GPs are entrenched and want "more GPs", not all simply say "it's too much"...there is a huge carder of them who actually are very VERY open minded about working..differently..appreciate the help specialists can give..stay away from the sarcasm laced comments about "you can't do my job" and actually are bending over backwards to work with different quarters of the system to make care better, looking at different ways of delivering care.
To those who form an opinion about primary care based on social media or the general media ( or even the generation next who aren't sure about taking this profession up) , let me offer you a counterbalance. There are two extreme opinions in the ether...one is that they are lazy fat cats who earn in the most six figure salaries and form the top 4% of the earning population and don't do weekends or out of hours. The other is that they work day in, day out, and are drained to the hilt, on the verge of quitting and work in a battle zone . The reality is that both those extremes do exist but the majority sit away, as with any debate, from the extremes.
Where do I base that opinion from?Locally I have had now nearly 5 years experience of working with 83 GP surgeries along with travelling up and down the country discussing with primary care and meeting GPs everywhere you can name.  I don't know whether its just by coincidence that I meet nice people or we are just blessed with good primary care colleagues but I have yet to meet the snappy ones who offer judgements or opinions in 140 characters and will not brook any further debate or care to stick to the archaic terms of "primary care" and "secondary care". Hospitals are part of the community..lets get that fact straight. Not separate.

Just to emphasise that Swan Surgery wasn't an outlier, this week I also visited Denmead surgery...again, 4 GPs in attendance, practice nurses, practice managers, discussion over lunch, reference to studies, discussion of Yudkins controversial talk on pre diabetes ( check it on YouTube..it's fascinating), chat about clearing up the confusion for type 1 diabetes patients as to where they should have their essential health checks done if under hospital care...what can I say? It was fun, it was enjoyable, it was a privilege to be out there amongst such fantastic GPs. Did we jest about those letters from secondary care? Of course we did..but not in anger, not with sarcasm..it was more with a need to ensure we do get the process right. The best decision we ever made as a diabetes team was to decide, apart from the super specialised bit, not to do clinics in isolation in the community. It has been an amazing experience working with GPs...you can never discount the human touch, the education provided by face to face ..and that's a 2 way education..respect doesn't come from reading documents and stamping your foot harder, it comes from talking to a fellow professional and understanding that all at on the same side, just with different skills.

So, you know what? Try it, try going to GP surgeries and vice versa..make your OWN opinion about GPs after meeting with them. I promise you one thing...it will be fun. It has been for us over the last 4-5 years and to the question what has the super six model of care done? Outcomes are come slowly...but it has done one fundamental thing...it has shown us the value of GPs and specialists working together..as colleagues...while having some fun along the way.

  

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