GPs complaints regarding work life balance

Soldato
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Bad schools.

Every single teacher I know (secondary and primary) working in schools graded between special measures and outstanding have the same issues with work load and needing to work majority of their holidays.

Not bad schools at all.
Where do you work? Only deluded Senior leaders have the stance you have.
The headteacher I spoke to disagreed with this so I suppose it's down to who you believe. He claimed that teachers do a bit of work in their holidays but it isn't much and the only reason to do more is poor time management. He as a headteacher pretty much had all of the school holidays off.
 
Soldato
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My 2p but everyone expects 9-5 as normal but it just doesn't cut in today's 24 hour society. I am not a doctor but a manager of around 40 people so first in last out. Everyone did overtime and being at the top meant you had to do even more overtime. For the past three years I have been working on a shift based 12 hour shift. Overtime has gone down to basically nothing and I only work half the year. Maybe doctors need to go down this route due to the fact surgeries are just open for longer now.

Does a 24 hour society change our needs as human beings physiologically?
 
Soldato
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Bad schools.

Every single teacher I know (secondary and primary) working in schools graded between special measures and outstanding have the same issues with work load and needing to work majority of their holidays.

Not bad schools at all.
Where do you work? Only deluded Senior leaders have the stance you have.
I am not a senior leader though I work throughout multiple school sites so know a large amount of Teachers. Most of the staff are given a decent amount of time within school hours to do paperwork so they don't have as much to do at home. When I was Teaching myself I rarely did anything at home. You do have to do the odd day or week but not every holiday all holiday. A lot Teachers around here will say do the first week of the summer holiday and then nothing for 4 or 5 weeks. I always took the first week off, worked 2nd and then took rest off. I am aware some schools have a really bad work/life balance but that doesn't mean every school and every Teacher has that bad balance. That's a myth that people in bad schools tell themselves so they feel like its normal when its not.
 
Soldato
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I am not a senior leader though I work throughout multiple school sites so know a large amount of Teachers. Most of the staff are given a decent amount of time within school hours to do paperwork so they don't have as much to do at home. When I was Teaching myself I rarely did anything at home. You do have to do the odd day or week but not every holiday all holiday. A lot Teachers around here will say do the first week of the summer holiday and then nothing for 4 or 5 weeks. I always took the first week off, worked 2nd and then took rest off. I am aware some schools have a really bad work/life balance but that doesn't mean every school and every Teacher has that bad balance. That's a myth that people in bad schools tell themselves so they feel like its normal when its not.
Unfortunately the climate at the moment is pushing teachers to work the max allowed in regards to contact time.

There are teachers on my school which only do 34hours a fortnight. Yet others like me doing 45hours a fortnight contact time. And we are expected to the same same amount of paperwork and more due to having more classes and more data to crunch.

It's such a minefield, I suppose it is hard to get down to the nitty gritty.

My teacher friends are all on max allocation. One quit this year because her school changed her from a 32hour timetable to a 45. She lasted a month then broke.
 
Soldato
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The headteacher I spoke to disagreed with this so I suppose it's down to who you believe. He claimed that teachers do a bit of work in their holidays but it isn't much and the only reason to do more is poor time management. He as a headteacher pretty much had all of the school holidays off.
Headteacher, say no more.
Most don't even teach. Some do a 20% teaching allocation to keep skills up.
They have absolutely no idea what it's like as a fully allocated teacher in the current climate.

I used to work with a member of senior leadership, they had a 30% teaching allocation. And when ever a member of staff complained that there was no time, they just accused them of poor time management because they were able to handle the work load fine. Ignoring the fact a teacher doing 30% Vs a teacher doing 90% is doing a completely different job
 
Soldato
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Headteacher, say no more.
Most don't even teach. Some do a 20% teaching allocation to keep skills up.
They have absolutely no idea what it's like as a fully allocated teacher in the current climate.

I used to work with a member of senior leadership, they had a 30% teaching allocation. And when ever a member of staff complained that there was no time, they just accused them of poor time management because they were able to handle the work load fine. Ignoring the fact a teacher doing 30% Vs a teacher doing 90% is doing a completely different job
Like I said its the bad schools that have problems not a flat out thing across all schools. Management just accusing them of poor time management puts them into what I class as a bad school.
Across the sites I am at the Teachers sat down with management to look at workload reduction. We implanted a new marketing policy that takes massively less time, cut down on unnecessary emails, created new easier to do literacy targets, all sorts of systems got implanted for Teacher workload reduction. Workload is now lower then it has been in years. They still work hard its just more efficient now so doesn't take up holiday time. The management across multiple schools around here often look at ways to reduce workload.
 
Caporegime
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Like I said its the bad schools that have problems not a flat out thing across all schools. Management just accusing them of poor time management puts them into what I class as a bad school.
Across the sites I am at the Teachers sat down with management to look at workload reduction. We implanted a new marketing policy that takes massively less time, cut down on unnecessary emails, created new easier to do literacy targets, all sorts of systems got implanted for Teacher workload reduction. Workload is now lower then it has been in years. They still work hard its just more efficient now so doesn't take up holiday time. The management across multiple schools around here often look at ways to reduce workload.

And how do you do that in schools where they literally don't have the budget to pay for enough teachers to cover the required number of hours?
 
Associate
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If I could turn back the clock and was back at school, a job in medicine is probably what I would have picked to study on.

The sad truth is that if you asked the same question of a group of GPs there is a high chance you would get them saying they would choose anything else. The job is very unlike what most people think it is. If it was working like Dr Brown Bear then fine its a doddle, but that isn't the truth. Even Doctors in other specialties often have no real idea of what it is like working as a GP unless they have done an F2 job in it, because undergraduate exposure is so woefully lacking. Even in places where they get some exposure they don't actually see the realities just as students don't see the realities in any speciality as they are learning not working.

Most healthy people on a forum like this don't use primary care on a regular basis and really wont know what we do. Those that do probably appreciate that even if things aren't perfect that without primary care their lives would be significantly tougher. Most of you probably assume that what we do is pat the heads of the 'worried well' all day long and see coughs and colds, interspersed with 'obvious' conditions that need a specialist to sort. The reality is that we are seeing undifferentiated problems that could be anything or nothing all the time that needs careful assessment, as well as the ongoing management of their chronic conditions and multi-morbidity. Some of what we would be doing in primary care routinely would have been secondary or even tertiary hospitals 20-30 years ago. Sure I do see some people that to me feel like a waste of my time and experience, but I'm also aware that for them they have real concerns or fears. My coughs and colds and minor ailments are 99% seen by my nursing team, and only get to me when a) all nursing appointments are used b) the patient wont give any information to our reception triage and demand a GP not a nurse. There is also a huge amount of administrative tasks to be done, whether its reading letters, writing letters, actioning results, requests from patients, dealing with prescriptions and their enquiries. Although anything that can safely be delegated to non clinical staff members will be, it can't all, and it means everything that cant needs to have a decision made on it by a GP. These can be quite complex and important decisions and not a simple black and white decision. The sheer number of important decisions made a day can be quite exhausting at times which is the issue that most of the professions is struggling with. Decision fatigue is real. 12 hour shifts are increasingly common and probably now towards the norm rather than exception as extended hours and extended access systems have become the norm and funding changes has meant practices essentially have to offer these or see their incomes drop hugely. This has massively changed since I qualified as a GP nearly 15 years ago. I used to be able to always run to time, have a good lunch break and be going home by 6 at the latest when I first qualified. I remember having the time to go and have a nice walk over my lunchbreak even on a regular basis. Now I'm 11-12 hours a day and often doing tasks at home via logging in with VPN services.

I know I'm well paid. I don't dispute that, although I don't think I'm overpaid either. If there were a magical huge number of new GPs and the funding to put them into surgeries that means I could see less patients and do less admin and get home earlier then I would be all for that. There aren't. The government know this. They have tried hard over the last few years and simply cant recruit enough to even maintain current numbers, let alone increase them, so the workload continues to increase, which is why the professions is increasingly stating this as an issue. They have now essentially given up on that plan and it's all about finding other allied health professionals to put into surgeries to see if they can see increasing numbers of patients for us instead. It might help to some degree, but it isn't going to be a magic bullet. One of the strengths that a GP has over all others health professionals is enough of an understanding of everything that when they come and see me with their knee and then mention something else which pricks my ears up. I have to do something about it, and I can. If they book with their knee to see a physio they will get their knee sorted and quite possibly even better than by myself, but the physio wont be asked about the other thing so they either need an appointment to see me for that, or if they did ask the physio they probably wouldn't have had their ears pricked by certain symptoms and it may be missed entirely.

I know its hard to ever win an argument about the value of your own work, and especially when you are well paid, but if you think that it's a simple job that anyone can do, and essentially money for old rope then the reality is very far from that.
 
Soldato
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Hello GP here.

An excellent post. Thanks for sharing your first hand experience of life as a GP. As GP registrar in my last few weeks I couldn't disagree with a single word there.

There are so many inaccuracies in this threat I really can't be bothered to respond to them individually and Buddy's post is a very honest and true reflection of the experiences of most GP's. Everybody entering medicine knows the demands of the career and I've not met a single GP who has ever complained about the pay.
 
Man of Honour
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Talking of teaching, we are frequently finding innacuracies in the homework set for our kids. Also when I was choosing high schools for them I would question the IT teachers at the open days and most didn't really know the subject.
 
Soldato
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Fair play for your detailed and informative post.

Without wanting to undermine the quality of your training, why would it not be possible to have some form of vocational career progression from lower NHS roles, eg nursing, into GP roles or some form of assistant GP role?

Out of interest how many patients do you see who already know whats wrong with them having googled it before hand? I appreciate this will vary by age group.

Would there be certain symptoms that without question just get referred on for further checks? If so, why not make that process more automatic?

People who have chronic conditions requiring ongoing management - wouldnt it make sense to take them out of the gp system and into some more streamlined and efficient process? Why do you have to keep signing repeat prescriptions if someone has a condition for life? For example my dad has epilepsy, he has to bother the doctor every couple of months for his repeat prescription which is really a waste of everyone's time. How much time would be saved if this was more streamlined? Maybe if this was improved people with serious conditions wouldnt get missed or misdiagnosed.

I fully appreciate im not qualified in this area but hey this is the internet you know how it is.
 
Caporegime
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Fair play for your detailed and informative post.

Without wanting to undermine the quality of your training, why would it not be possible to have some form of vocational career progression from lower NHS roles, eg nursing, into GP roles or some form of assistant GP role?

Out of interest how many patients do you see who already know whats wrong with them having googled it before hand? I appreciate this will vary by age group.

Would there be certain symptoms that without question just get referred on for further checks? If so, why not make that process more automatic?

People who have chronic conditions requiring ongoing management - wouldnt it make sense to take them out of the gp system and into some more streamlined and efficient process? Why do you have to keep signing repeat prescriptions if someone has a condition for life? For example my dad has epilepsy, he has to bother the doctor every couple of months for his repeat prescription which is really a waste of everyone's time. How much time would be saved if this was more streamlined? Maybe if this was improved people with serious conditions wouldnt get missed or misdiagnosed.

I fully appreciate im not qualified in this area but hey this is the internet you know how it is.

Like the old saying goes, Only a fool has himself for a client, so why would you want to self diagnose and see someone less qualified?

I don’t get it....as a patient, do you want someone who knows less medicine?
 
Soldato
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Like the old saying goes, Only a fool has himself for a client, so why would you want to self diagnose and see someone less qualified?

I don’t get it....as a patient, do you want someone who knows less medicine?

Im working on the basis that 90% of patients dont really need that much help. Those 10% that really do are the ones that are most at risk of being misdiagnosed or underdiagnosed and i hate to think that the ones who really need the help are having their chances of survival undermined by timewasters.

Id rather see money spent on routine health check ups for everyone, like how we have eye tests every two years. A thorough examination which checks for all the common terminal illnesses. Women get smear tests, what do men get? what do women get other than smear tests? what do kids get?
 
Caporegime
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Im working on the basis that 90% of patients dont really need that much help. Those 10% that really do are the ones that are most at risk of being misdiagnosed or underdiagnosed and i hate to think that the ones who really need the help are having their chances of survival undermined by timewasters.

Id rather see money spent on routine health check ups for everyone, like how we have eye tests every two years. A thorough examination which checks for all the common terminal illnesses. Women get smear tests, what do men get? what do women get other than smear tests? what do kids get?

Are you not playing Russian roulette at misdiagnoses due to the lack of training and missed symptoms and then somebody actually may die?

I guess they can do a massive disclaimer - see this less trained medical professional at your own risk, if you die, tough luck.
 
Soldato
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The regular checks could detect terminal things sooner. How many people with cancer dont find out till its too late? A guy at work died last year from pancreatic cancer in late 50s. he didnt know he had it and he'd been under the care of his gp for blood pressure for years.
 
Soldato
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And how do you do that in schools where they literally don't have the budget to pay for enough teachers to cover the required number of hours?
Again I would put that down to a bad school with bad management. Working in a school with bad management and a staff shortage is a nightmare and does create a situation with overworked staff. But as I said before not all schools are like that and that is not normal. I admit there are some really terrible schools to work for but it is not fair to blanket statement all schools and all Teachers like that just because you had a bad experience in one. Some school management teams do care about staff workload and do handle the budgets correctly so they have enough of the correct staff.
 
Soldato
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Then why is the less trained person with less knowledge doing health checks?

No im calling for more mechanistic checks, more hard testing. Not just describing symptoms to someone. Regular blood screening, heart scan and hormone checks for example.

I appreciate that many people dont give a crap about their own health until its too late. not sure what to do about those tbh.
 
Soldato
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Talking of teaching, we are frequently finding innacuracies in the homework set for our kids. Also when I was choosing high schools for them I would question the IT teachers at the open days and most didn't really know the subject.

This is because GCSE ICT was scrapped a few years ago.
They moved to Computer Science. Unfortunately most of the teachers teaching the subject are Ex-ICT techers who were forced to teach it as "Its the same thing"... Which its not, only has a 5% overlap at best.

Those teachers are learning on the job and retraining in a new subject, which is why some cannot answer basic questions.
 
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