Working Life

What is an average day like?

Most GP surgeries are contracted to be open and available for patients from 8.30am to 6.30pm, although many GPs need to be in surgery from before 8am and after 6.30pm. Some also undertake shifts in the out-of-hours rota or in research. GP surgery visits have significantly declined over the years, but the length of time dedicated to seeing patients has increased proportionately so hours have stayed approximately the same.

The GP’s day is one continuum of activity, with many decisions taken and much work generated. Appropriate supporting staff play their part, and many doctors try to meet up with their colleagues throughout the day to sign letters, prescriptions and catch up with relevant events. Meetings with other primary care team members, such as health visitors and district nurses, are also arranged on a regular basis as needed.

A substantial part of the GP’s work nowadays is spent managing long term conditions such as:

  • Hypertension
  • Cardiovascular diseases
  • Diabetes
  • Asthma
  • Arthritis
  • Chronic kidney disease

GPs regularly need to deal with emotional, stress-related and other mild to moderate psychiatric illness.

Results of tests must be checked daily, and with almost universal computer links to the hospital laboratory this is done via computer, with direct access to the patient’s clinical record. Actions resulting from the investigations, such as contacting the patient and changing therapy, are then all sanctioned by the GP.

Flexibility and the ability to prioritise workload on the basis of clinical need is the key to being a GP. No two days are the same and the organisation of the practice is central to delivering safe high-quality services.

What are the hours like?

A full-time GP will work approximately nine to ten hours per day, and there is currently the ability to opt out of out-of-hours care at night and weekends. Some GPs do enjoy taking part in out-of-hours services, but such arrangements depend on individual practices.

Where is the work based?

Work is based in the surgery, in the patient’s home, in homes for the elderly and sometimes in specialist accommodation for those with chronic disability. In the case of GPs with special interests, or who act as clinical assistants to consultant units, patients may be seen in hospital outpatient clinics or wards.

GPs may work in group practices, health centres or more infrequently single-handed practices in rural and inner-city practices. A number have portfolio careers, which include work in education as medical school teachers and researchers.

What people work in the same team?

A wide range of primary care team members work alongside the GP, making general practice a very enjoyable specialty. They may be employed by the GP or attached to the practice, and include:

  • Practice-employed nurses
  • Practice managers
  • Health visitors
  • Midwives
  • Community nurses
  • Physiotherapists
  • Occupational therapists
  • Speech therapists
  • Psychiatric and other specialist nurses
  • Dieticians
  • Counsellors
  • Community pharmacists are increasingly involved in medicine management

Types of patients 

Patients are delightfully varied, and of all age groups, social classes and ethnic groups. The key thing is that a GP is a generalist, seeing undifferentiated presentations.

Number of patients seen in a day

On average, a GP will typically see 30-40 patients in a day. GPs may make additional contact with patients through phone calls and email. Prescription queries and results handling (notifying results) can sometimes double the total number of patient contacts.

What is most enjoyable?

There are many enjoyable aspects of working as a GP, including:

  • The ability to treat patients as people rather than as ‘diseases’ or ‘cases’
  • The experience of building effective, trusting relationships to provide an extended knowledge of the patient and families
  • Dealing with all age groups, types of disease and problems
  • Working in the community close to and accessible by patients
  • Working in teams
  • The high standard of training
  • The systems available for support such as appraisal, clinical governance and education
  • The flexibility and opportunity to innovate and improve services

Furthermore, compared with hospital colleagues, many GPs remain independent contractors and still have an enviable degree of autonomy. The decision to invest in extra equipment and new staff remains very much the practice’s choice.

What is most challenging?

Challenging aspects include:

  • The undifferentiated nature of many problems presented
  • The unpredictable nature of work, as no two days are the same
  • The need to tolerate uncertainty and make risk assessments
  • Demanding complexity and dealing with psycho-social issues  - this may also be very rewarding if done well and with support
  • Keeping up-to-date with the enormous range of diseases and service changes
  • The challenge of dealing with complex problems within the standard ten-minute consultation

Opportunities for flexible working

There are many opportunities for flexible training. Local education and training boards (LETBs) try to facilitate requests for flexibility in training within financial and working constraints. Many GPs opt to work less than full-time once they have gained entry to the GP register, and opportunities to continue with flexible working throughout your career are plentiful.

Opportunities for research and teaching

Research and development (R&D) is carried out through university departments, NHS research networks and pharmaceutical companies. There are also opportunities for undergraduate teaching, postgraduate training and continuing professional development (CPD) tutoring.

Other career options for GPs:

Opportunities outside of traditional general practice include:

  • Roles in clinical management, GP appraisal and as a CCG (Clinical Commissioning Group) medical director
  • Royal college work, for example as an examiner, or achieving the Fellowship of the RCGP (Royal College of General Practitioners)
  • As an adviser to CCGs and other health service bodies
  • Voluntary work in the community and for charities
  • Sessional doctor
  • Learning Set Member and Convenor
  • Foundation supervisor
  • GP trainer
  • Programme director
  • GP with Special Interest
  • Out of hours work
  • GP Tutor
  • Mentor
  • Commissioning lead
  • Commissioner
  • Prison doctor
  • Armed forces

What it's like to work in this field

"Having completed various SHO posts, I responded to an advert to do a GP traineeship (GP registrar post) in a rural practice and thereafter was completely hooked. As a GP, I’m able to combine science with personal medicine. I feel I can support my patients better by living and practising amongst them, sharing their concerns and understanding their illnesses in relation to their lives as a whole. Family medicine quickly revealed itself as a most rewarding ingredient.

"Being part of a primary care team allows great flexibility, influence over practice policy and a timetable which enables me to combine GP with hospital sessions and teaching.

"Despite the intensity and challenges, it is possible to have a very reasonable work-life balance, and the rewards both in human and professional terms have exceeded all my expectations."

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