GP hours? - study medicine

ahh i thought this was why. Still don't get how they fit all of that into a week anyway. crazy!

Hi,

I have read somewhere that GPs work 9 sessions a week, with that being 2 sessions a day. so what do they do in the final half day? Just been thinking about it for a while

There are hardly any full-time GPs left any more, they are a dying breed. This is because our core hours are now 8am to 8pm (although we can farm out 6.30-8pm and weekends if we wish), so in 3 days we work what most people consider a full-time job, and that is without the stuff needing to be done before and after surgeries.
Today I have seen or spoken to 35 patients, dealt with about 30 direct questions about patients, read and actioned 34 clinical letters/reports, reviewed and actioned 48 pathology results, reviewed and authorised about 60 prescription requests, organised 2 referrals, done 2 home visits, completed an insurance report, a DWP report, a DVLA report and a trial entry information request. Plus offered clinical support to our nurse prescriber, had a clinical meeting with the other practice doctors and done a palliative care meeting. No management work this week as our Practice Manager is on holiday (though it will be double next week when they are back!), though I did sign some weird thing about the new GP networks - now I have to read it.......!
This is pretty standard, though I was a bit busier than usual as punishment for having been on holiday for a week!!
I started at 8.30 (though was on call from 8, when OOH knock off) and finished at 8.30. Plus a 25 minute commute each way. Now just about to log on for a final clear up of late results, emails, OOH letters etc. And tonight was not late surgery (that is tomorrow when last patient is booked for 8pm, again with an 8am start)
I have also taken a child to school, cooked them tea, done 2 loads of washing, unpacked my bags from my time away and supported a friend whose mum has just been diagnosed with cancer.
I then need to find time to do some audit, prescribing leads/medicine management work, ALL the e-learning, CPD, and when the students start up again, teaching and mentoring and reviewing their work, etc, etc.

So 4 days a week (8 sessions) is the maximum anybody I know works now, and that would equate to about 50+ hours a week for most Partners in a standard GP practice. A lot of people now have a portfolio career, so do some GP work, plus a myriad of alternative jobs. The Dr I worked with today does 4 sessions in A&E, the one I am on with tomorrow only locums, the one I am working with on Friday is a clinical director for OOH, the one next week is a Public Health Dr and NHS IT guru. I also know ENT GPwSIs (GP with a special interest), Ophthalmolgy GPwSIs, Breast clinic GPwSIs, Gynae GPwSIs, Haematology GPwSIs, G,astro GPwSI those who work with the CCG or run ICCs, and that is just off the top of my head. GP is too busy now to be done full time at the coal face (and I can say this as somebody who has previously had a portfolio career of my own and is married to a full time hospital consultant - and not that I am saying everybody isn't busy, cos we are!)

PS Most days, I LOVE my job!!

lol jeeez busy busyyy. Do locums work the same long hours?

Also, you are only counted as part time if you work 3 days for example, even though you are still working 36 hours?

In GP if you want a less full-on career is it possible? like by not becoming a partner etc.?

Do you know any GPs/ doctors in general who have left medicine? What do they do instead now?

Thank you for your reply, it was really insightful.

There are hardly any full-time GPs left any more, they are a dying breed. This is because our core hours are now 8am to 8pm (although we can farm out 6.30-8pm and weekends if we wish), so in 3 days we work what most people consider a full-time job, and that is without the stuff needing to be done before and after surgeries.
Today I have seen or spoken to 35 patients, dealt with about 30 direct questions about patients, read and actioned 34 clinical letters/reports, reviewed and actioned 48 pathology results, reviewed and authorised about 60 prescription requests, organised 2 referrals, done 2 home visits, completed an insurance report, a DWP report, a DVLA report and a trial entry information request. Plus offered clinical support to our nurse prescriber, had a clinical meeting with the other practice doctors and done a palliative care meeting. No management work this week as our Practice Manager is on holiday (though it will be double next week when they are back!), though I did sign some weird thing about the new GP networks - now I have to read it.......!
This is pretty standard, though I was a bit busier than usual as punishment for having been on holiday for a week!!
I started at 8.30 (though was on call from 8, when OOH knock off) and finished at 8.30. Plus a 25 minute commute each way. Now just about to log on for a final clear up of late results, emails, OOH letters etc. And tonight was not late surgery (that is tomorrow when last patient is booked for 8pm, again with an 8am start)
I have also taken a child to school, cooked them tea, done 2 loads of washing, unpacked my bags from my time away and supported a friend whose mum has just been diagnosed with cancer.
I then need to find time to do some audit, prescribing leads/medicine management work, ALL the e-learning, CPD, and when the students start up again, teaching and mentoring and reviewing their work, etc, etc.

So 4 days a week (8 sessions) is the maximum anybody I know works now, and that would equate to about 50+ hours a week for most Partners in a standard GP practice. A lot of people now have a portfolio career, so do some GP work, plus a myriad of alternative jobs. The Dr I worked with today does 4 sessions in A&E, the one I am on with tomorrow only locums, the one I am working with on Friday is a clinical director for OOH, the one next week is a Public Health Dr and NHS IT guru. I also know ENT GPwSIs (GP with a special interest), Ophthalmolgy GPwSIs, Breast clinic GPwSIs, Gynae GPwSIs, Haematology GPwSIs, G,astro GPwSI those who work with the CCG or run ICCs, and that is just off the top of my head. GP is too busy now to be done full time at the coal face (and I can say this as somebody who has previously had a portfolio career of my own and is married to a full time hospital consultant - and not that I am saying everybody isn't busy, cos we are!)

PS Most days, I LOVE my job!!

I'm a second year medic and it's so motivating to get an insight into what you do. You're an absolute hero! Hearing that you still enjoy your job most of the time kinda makes all the studying worth it because that's the end goal!

Thank you. Most medics I know actually still enjoy their jobs, but I do fear we have had the best of medicine as a career.....!
Good luck with your course, I remember you from when you applied!

Aww don’t say that!!! 😀

Every medic I know of a similar age says what made our ridiculous training bearable was that you were part of a team. You belonged to a "firm" and had people above you and below you who had your back. I had a consultant I worked with as an SHO who used to tell a patient on the post-take ward round "This doctor here saved your life last night" whilst pointing to whoever had admitted the patient. He was the weirdest guy ever, and had odd rituals that drove us all MAD, such as how Sister had to set the tray for coffee, or how he would refuse to see a patient if the notes weren't in the correct order, but he was endlessly supportive and respectful of his juniors, and because we worked with him all the time, we learned how to work round his little foibles. Consultants and Registrars would know where you were, when you had been on call, when you were struggling, when you were just plain exhausted and we all worked together to make our lives bearable. We spent so much time together, we became like family (my bosses, peers, juniors and the nurses all came to my wedding!). As a surgical HO on a floor with 3 others, we would each have an awful day of seemingly unending elective admissions (no pre assessment or Nurse clerking in our day and TURPs, colonoscopies and hernias/varicose veins, etc were still clerked by the HO on the day of admission/day before) and when the other 3 had finished their work, we would all pitch in to finish off the 40+ people needing clerking, because we knew tomorrow it would be us. None of us left until all of us could. The juniors often lived together, too, as the Drs Res was still a thing. On my first night as a surgical HO I was called at 3am to a post op patient who had gone off big time and I was so scared as he looked awful and I had no idea what to do to stop this man from dying. I called my SHO (who was in bed, the HO dealt with everything in those days) and he turned up, sat on the windowsill of the room and just said "Tell me what you found?" As I talked through the breathless, clammy, tachycardic, bi-basal creps, the stuff I had learned at med school all came back and I was able to say "LVF!!!" like I had discovered the moon. He simply nodded and asked how I would treat that. This had been drilled into me at med school and the "sit them up, O2, frusemide, ECG, assess for inotropes, etc, etc" was a rote I knew well and was able to just follow it through and the pt was better in an hour. All this time my SHO just sat smiling and nodding on that windowsill. Had he taken over, or simply told me what to do, I would probably never have developed any confidence at all, but we were a team and always on the same side (he is a retired consultant now and we still exchange Xmas cards).
Doctors today have lost this sense of belonging and of all being in it together, to a greater or lesser degree. The modern shift working and variable colleagues on a daily basis means you do not feel the same sense of ownership and belonging as we did, I feel. I looked after my own ward, knew all my patients, they all knew me. I wrote their discharge letters and because I had been involved in every step of their stay, I knew the story in detail, so that side of it was easy. The Consultants were very much more God-like, but they were our gods, and nearly always on our side.

If I sound nostalgic for those days, don't be fooled. My first Xmas on call I worked from 8am Wed to 6pm on Monday solidly, with no break as the first on call surgical HO, both for wards and admissions and in those days you were not expected to call your seniors unless it really was beyond your expertise (Xmas was Fri, I was on call Wed and Fri/Sat/Sun, as we did 3 day weekends and saw no point in making somebody else miss Xmas by working the Thursday). I was so tired I cannot remember any of it, but I was fed, helped through by the nurses and other staff and my colleagues helped cover everything through the days they were there. Much of my junior doctor time involved a 1 in 3 with prospective cover, which meant I was on call every 3rd night with no time off afterwards, and on call Fri/Sat/Sun every third weekend, then having to work a normal Mon - Fri week after and all of that went up to 1 in 2 if somebody was on leave. I was left to cover situations that were, almost certainly, unsafe and beyond my competencies, but everyone else was doing the same thing, so it was rarely questioned. I do not think this was a good thing! I worked as a locum after my HO year and was the sole medical doctor on for a step down hospital covering 30 quite poorly people. I gave the med reg a fit when I rang him, told him a 45 year old had arrested and we'd got him back, but he was in SVT with aberrant conduction and I needed some adenosine (which was newish and the dog's bo**ocks!). He kept asking who I was and how I knew it was SVT not VT given I had no real medical experience. He was so concerned he got in a taxi and came the 15 minutes with the adenosine himself and accompanied the pt back to the big, shiny hospital in the ambulance (but it was SVT and he let me give the adenosine - sorry if this is too medical for most of you right now!!). This patient's life was put at pretty real risk by me being the only medic on site to deal with this sort of problem!

However, I did make friends I still have now. My Reg when I was an SHO is godfather to my eldest son, one of my fellow SHOs godmother to my middle son. I still speak to many of them, even if just via Xmas card, and I certainly learned a lot of medicine!! I think you learn in a safer way these days, but at the expense of the camaraderie, team-spirit and sense of belonging that we had and that side of it I feel is a sad loss.

Sorry if that is nothing like the response you were expecting

PS And sorry for derailing the thread!

The social changes are quite interesting. For example, I've never come across a single junior doctor-nurse relationship, whereas I do know of a few older consultants who married nurses so it seems that that used to be a thing? Coinciding with a large increase in the number of female doctors of course - around 60% of new med students now.

The social changes are quite interesting. For example, I've never come across a single junior doctor-nurse relationship, whereas I do know of a few older consultants who married nurses so it seems that that used to be a thing? Coinciding with a large increase in the number of female doctors of course - around 60% of new med students now.

Every medic I know of a similar age says what made our ridiculous training bearable was that you were part of a team. You belonged to a "firm" and had people above you and below you who had your back. I had a consultant I worked with as an SHO who used to tell a patient on the post-take ward round "This doctor here saved your life last night" whilst pointing to whoever had admitted the patient. He was the weirdest guy ever, and had odd rituals that drove us all MAD, such as how Sister had to set the tray for coffee, or how he would refuse to see a patient if the notes weren't in the correct order, but he was endlessly supportive and respectful of his juniors, and because we worked with him all the time, we learned how to work round his little foibles. Consultants and Registrars would know where you were, when you had been on call, when you were struggling, when you were just plain exhausted and we all worked together to make our lives bearable. We spent so much time together, we became like family (my bosses, peers, juniors and the nurses all came to my wedding!). As a surgical HO on a floor with 3 others, we would each have an awful day of seemingly unending elective admissions (no pre assessment or Nurse clerking in our day and TURPs, colonoscopies and hernias/varicose veins, etc were still clerked by the HO on the day of admission/day before) and when the other 3 had finished their work, we would all pitch in to finish off the 40+ people needing clerking, because we knew tomorrow it would be us. None of us left until all of us could. The juniors often lived together, too, as the Drs Res was still a thing. On my first night as a surgical HO I was called at 3am to a post op patient who had gone off big time and I was so scared as he looked awful and I had no idea what to do to stop this man from dying. I called my SHO (who was in bed, the HO dealt with everything in those days) and he turned up, sat on the windowsill of the room and just said "Tell me what you found?" As I talked through the breathless, clammy, tachycardic, bi-basal creps, the stuff I had learned at med school all came back and I was able to say "LVF!!!" like I had discovered the moon. He simply nodded and asked how I would treat that. This had been drilled into me at med school and the "sit them up, O2, frusemide, ECG, assess for inotropes, etc, etc" was a rote I knew well and was able to just follow it through and the pt was better in an hour. All this time my SHO just sat smiling and nodding on that windowsill. Had he taken over, or simply told me what to do, I would probably never have developed any confidence at all, but we were a team and always on the same side (he is a retired consultant now and we still exchange Xmas cards).
Doctors today have lost this sense of belonging and of all being in it together, to a greater or lesser degree. The modern shift working and variable colleagues on a daily basis means you do not feel the same sense of ownership and belonging as we did, I feel. I looked after my own ward, knew all my patients, they all knew me. I wrote their discharge letters and because I had been involved in every step of their stay, I knew the story in detail, so that side of it was easy. The Consultants were very much more God-like, but they were our gods, and nearly always on our side.

If I sound nostalgic for those days, don't be fooled. My first Xmas on call I worked from 8am Wed to 6pm on Monday solidly, with no break as the first on call surgical HO, both for wards and admissions and in those days you were not expected to call your seniors unless it really was beyond your expertise (Xmas was Fri, I was on call Wed and Fri/Sat/Sun, as we did 3 day weekends and saw no point in making somebody else miss Xmas by working the Thursday). I was so tired I cannot remember any of it, but I was fed, helped through by the nurses and other staff and my colleagues helped cover everything through the days they were there. Much of my junior doctor time involved a 1 in 3 with prospective cover, which meant I was on call every 3rd night with no time off afterwards, and on call Fri/Sat/Sun every third weekend, then having to work a normal Mon - Fri week after and all of that went up to 1 in 2 if somebody was on leave. I was left to cover situations that were, almost certainly, unsafe and beyond my competencies, but everyone else was doing the same thing, so it was rarely questioned. I do not think this was a good thing! I worked as a locum after my HO year and was the sole medical doctor on for a step down hospital covering 30 quite poorly people. I gave the med reg a fit when I rang him, told him a 45 year old had arrested and we'd got him back, but he was in SVT with aberrant conduction and I needed some adenosine (which was newish and the dog's bo**ocks!). He kept asking who I was and how I knew it was SVT not VT given I had no real medical experience. He was so concerned he got in a taxi and came the 15 minutes with the adenosine himself and accompanied the pt back to the big, shiny hospital in the ambulance (but it was SVT and he let me give the adenosine - sorry if this is too medical for most of you right now!!). This patient's life was put at pretty real risk by me being the only medic on site to deal with this sort of problem!

However, I did make friends I still have now. My Reg when I was an SHO is godfather to my eldest son, one of my fellow SHOs godmother to my middle son. I still speak to many of them, even if just via Xmas card, and I certainly learned a lot of medicine!! I think you learn in a safer way these days, but at the expense of the camaraderie, team-spirit and sense of belonging that we had and that side of it I feel is a sad loss.

Sorry if that is nothing like the response you were expecting

PS And sorry for derailing the thread!

One of my old Consultants told me his Hungarian mother cried when he said he wanted to become a Dr as "The only people doctors marry are nurses or prostitutes"!! This was because she believed they never had time to meet anyone else. He was married to a very lovely fellow Dr, but said his mum never got over his career choice.
When I was a junior doctor, some of the younger nurses used to draw lots to see who would have a go at the latest male doctor to come on the ward! Unfortunately, none of the male nurses ever did it the other way round.....!

My best friend is a Nurse married to a Dr, and many, many of our other friends are the same combination, although my work Partner is married to a bloke who does something with fossil fuels, or something...... And my other best friend is married to an ex-journalist, so a few keep relationships out of medicine

Thank you for sharing G. Very interesting read and I understand where you’re coming from. You have seen many changes in the profession so your comments should not be ignored.

It’s good to hear you still love your job though!

Thank you. Most medics I know actually still enjoy their jobs, but I do fear we have had the best of medicine as a career.....!
Good luck with your course, I remember you from when you applied!