General practitioners are specialist physicians trained in the
principles of their discipline. They are personal doctors, primarily
responsible for the provision of comprehensive and continuing care to
every individual seeking medical care irrespective of age, culture, sex
General practitioners exercise their professional role by promoting
health, preventing disease and providing cure, care, or palliation. This
is done either directly or through the services of others according to
health needs and the resources available within the community they serve,
assisting patients where necessary in accessing these services.
What are the attractions and challenges?
The professional life of a GP is varied and dependant upon a high
level of communication skills and clinical challenges. It is distinctly
different from hospital life. Social and psychological factors weigh
heavily in the diagnostic approach of the general practitioner. The GP
helps patients with early symptoms of illness as well as those with
chronic illness and GPs must be skilled in the long term management of a
large variety of physical and psychiatric problems. It is the wide mix of
general practice that it is one of its major attractions. No other
specialty offers such a wide remit of treating everything from pregnant
women to babies and from mental illness to sports medicine. General
Practice also provides an opportunity to prevent illness and not just
treat it. Team working is an integral part of the GPs role as is
management. GPs have the opportunity to develop specialised skills and
areas of expertise which can be clinical, educational, political or
related to health service management.
The challenges lie in the difficulties of separating individual and
population needs for health care and services. Service delivery is
influenced by local and national policy and, therefore can be subject to
rapid change so ‘keeping up to date’ through a well maintained programme
of Continuing Professional Development is vital to the role. Providing
high levels of personal care within well organised systems whilst
maintaining a work-life balance is the challenge faced by all GPs.
What is the future of GP?
GPs are highly valued and respected members of society providing a
crucial element of health care delivery. If General Practice didn’t exist
it would need to be invented afresh for cost effective health services.
General practice will, therefore, continue to thrive. Delivery models will
change along with general changes in political and societal expectations.
Developing an area of special clinical interest and expertise has
always been a part of the GPs role. This is becoming formalised into
service delivery and, in the future, specific accreditation for these
roles will develop. Areas of interest are varied and include dermatology,
urology, sexual health and mental health as a few of the many specialist
area being delivered by GPwSI (GP with Special Interest) services. These
are often practice based providing the care for the practice’s population
or contracted to the primary care commissioning organisation for wider
There are opportunities for graduate GPs to work part-time, flexibly,
salaried or in partnership. The range of options for working in primary
care will continue to expand as the delivery of patient care develops to
meet the needs of a changing society.
A trainee’s perspective:
"In GP training one has to learn a huge array of knowledge, skills and
attitudes. The one to one relationship GP Registrars experience with their
trainers is unique and hugely supportive. The teaching covers a wide range
of clinical skills with particular emphasis on communication and
interpersonal skills. The group learning facilitated by GP educators, in
protected time, is supportive for achieving the end point assessments
General practice provides the thrill of uncertainty:
not knowing what patients are going to walk into the consulting room with
next is challenging and rewarding. The multidisciplinary practice team is
like a family and one learns team dynamics and management skills
simultaneously. It is rewarding to observe the continuity of care and the
long term relationship, respect and rapport between GPs and their
patients. It is amazing to see the positive feedback received by the GP
and their team constantly and puts previous misconceptions to bed.
There is no doubt that primary care is going through
challenging times and with increasing investment, emphasis on prevention
and early diagnosis, patients preferring treatment options closer to home
and preferably by their GP, the opportunities that have risen are
As a GP trainee I actually found that choosing general practice as a
career option opens up numerous possibilities rather than limit one to a
beaten track. Despite pressures of work, watching a good GP practice shows
that this career choice is as much an art as it is science.