GPs leaving the UK

[Traveller3367]

DP is a HCP with lots of doctor friends.
In less than 2 years, 6 GPs have left the UK to work abroad (or are imminently leaving).
I read in the papers that 1 GP can care for upto 2000 patients so that's 12000 patients who have lost out.
AIBU to think there must be something about job that's driving them away?
The papers make it out to be easy and well paid but clearly not easy/well paid enough for some to stay and do it!
How can we keep our GPs in the UK to help us?

@Fairylights25

They should have to sign a minimum of five year NHS contracts if they are undertaking tax payer funded training.

Er they do 😂 Once out of med school they work for the NHS for 5 years. It’s not training lol you think if as uni, the doctor on the ward looks after your mum or the A&E doctor is that doctor. Bad language used. They are working as full time doctors who get learning experiences on the way. They are paid professionals, they don’t owe people fuck all

SIL and BIL are GPs and emigrated to Sydney 5 years ago.

They seem to have a better quality of life and work-life balance over there. They work less hours and get to spend more time with the children. Plus their incomes afford them a more luxurious home there compared to London.

I know several GPs that have left and are now working in other countries. I do think we need a bit of an overhaul in the U.K. it’s not exactly the best timing atm though - although it’s been coming for years! The pandemic is just shining a very bright light on it.

Hmmm. Some dubious information on this post.

DH is a GP. It's a horrible job. Less than 60k for 3 days a week, some days he works 8am-1am. Treated like a pretend doctor as not a specialist, 10 minute appointments, constantly extra patients or home visits squeezed in. It's impossible. If there were any financial alternative for him to quit he would. Possibly to retrain in A&E.

Yeah- big career mistake he would say.

Unfortunately the workload in general practice is ridiculous. GPs have so little time to see patients, some who have very complex issues. Then there’s the massive amount of paperwork they have to do. DS was thinking about medicine as a career and tbh I encouraged him to consider other options. You can make better money elsewhere for far less work and stress. Unless he’s set his heart on it for all the right reasons I wouldn’t encourage him in that direction.

@Fairylights25

I am truly past caring. Really. I don't care. I am so tired of the endless whinging.

That’s fine as long as you don’t want to access any healthcare for you or your family. Bet if you do need it you will be the one whinging!!

Absolutely with the heart sinkers. Since social care has been cut so much they are coming into the surgeries more often and asking for help that the GP can't give them. You cannot fix the NHS without fixing social care as well.

I don't think that we should recruit more GPs, I think that we need to totally change the system.

People want A&E and Urgent Care Centres 24 hours a day. We don't need GPs to refer us for treatment, lots of countries allow patients to refer themselves and it works fine.

We need specialist mental health practitioners dealing with mental health problems, not GPs.

We need to change the whole system. GP practices don't work.

@ILoveAllRainbowsx

I don't think that we should recruit more GPs, I think that we need to totally change the system.

People want A&E and Urgent Care Centres 24 hours a day. We don't need GPs to refer us for treatment, lots of countries allow patients to refer themselves and it works fine.

We need specialist mental health practitioners dealing with mental health problems, not GPs.

We need to change the whole system. GP practices don't work.

I fully agree. The GP system is an antiquated concept and it's time to scrap it and replace with a modern "fit for purpose" system. We've come a long way since the 60s/70s where the GP would deal with virtually everything, i.e. local emergencies, such as road accidents, births, etc. GPs have basically become deskbound "gatekeepers". Patients need direct access to more treatment options, such as, as you say, urgent care centres, and local "clinics" akin to what they have in mainland European countries that deal with all manner of issues, particularly minor injury treatments and prescriptions.

People are calling for the GP system to be "fixed", but in reality, it needs scrapping.

Interesting array of opinions
Wish I could respond to each individually but many points repeated

Those that say "good riddance" to the ones doing it for the money, have you thought of an alternative? The current system is a mix of those who love patients and those who love money. If we lost a chunk of those who do it for the money, would you be happy to wait an extra 2-3 weeks for an appointment?
IMO as long a doctor provides me a professional and competent service then I don't care what his/her motivations are for doing the job. Caring alone doesn't guarantee the best patient care. I think the days of vocations are coming to an end with increasing value on work life balance and mental health.

Secondly yes there are many reasons for poor lifestyle choices and addictions which massively impact health. But there is also a significant role for society/ community / family / friends for these people. It seems as though some patients expect the GP/NHS to replace all these support systems and then feel hard done by and unsupported. Even most mild/moderate mental health problems can be managed better with healthy living, exercise, social interaction etc

Also re jobs abroad. I have heard of jobs being advertised with unimaginable perks. I've heard of a few people off to Qatar / Dubai for £100K+ tax free jobs, free housing, free medical care, free private schooling, free flights. Seems like other countries (ME, Oz, NZ, Canada etc) seem to value the hard work it takes to become a doctor more than the UK.

Regarding the concept that those trained in the UK need to stay here and repay the tax payer. Such a fallacy. Doctors are trained on the job so the doctor treating you in A and E, and getting paid for it, is usually still training. What the taxpayer pays for is time for learning/ teaching but I've heard many doctors complain about how they aren't given that time to attend teaching sessions. Add in all the extra hours they do and I think you'll find the tax payer owes the doctors money and not the other way round!

Those stating GP is an easy role, why are you not training to become one? Clearly if they are getting paid for playing golf then most people would be training to become one?
Sad to see these highly trained professionals being so undervalued. Most have been working hard and studying since very young and seems a shame they are being run out of the country they wanted to serve

I'm a senior registrar in a hospital specialty, about 1 year off becoming a consultant. I am in my late 30s and still working nights and weekends. I do procedures every day that could easily kill people, and I deal with the sickest patients in the hospital. By the time I complete my training it will have been almost 20 years since I started medical school (admittedly slowed down a bit by having two kids and working part time). If I had gone down the GP route, I could have qualified as a GP in 2014, and been working independently since then, no nights or weekends if I didn't want. I'd have finished training before having my kids, so my career wouldn't have stalled so much.
And yet I wouldn't do it for any money.

A lot of my friends who are GPs are miserable at the moment. This is not the job they envisaged. They want to be seeing patients, giving them the time they deserve. They don't want to be snowed under with ever-increasing demand, having to deal with things on the phone that would be easier to see F2F (I think they all agree that telephone consultations are appropriate for some things but it's not most people's preferred method of working). They don't want to have so many patients to see that there is no time for admin in a normal day, meaning they regularly stay late to finish all that. They don't want to have to start half their consultations apologising for themselves.

Things have changed so much in the last few years. The expansion of ANP/similar roles means that a lot of the mentally "easier" appointments like pill checks, medication reviews etc, are no longer in the GPs remit. So they only have the complex stuff - the elderly patients with multiple comorbidities, the patients with mental health problems and terrible social situations, the ones who've been bounced around multiple clinics and nobody can quite work out what to do. Lots of complex patients that would normally be managed by a hospital clinic are now sent for "shared care" or just discharged back to the GP, who has to work out what to do for them. This is not the fault of the hospitals, who are under huge pressure to cut clinic numbers as well, as they can't keep up with seeing all the new patients. There's no mental "breathing space" in a day. And the government and the press whips up more hatred every week. GPs are going off sick with stress and MH problems more and more frequently, which only increases the pressure on those left behind.

It's not about the money. The pay is decent, considering the amount of training and the skill required for the job, but it's not amazing. I think a majority of the people who leave, do so for better working conditions, not for the money itself.

More admin staff would probably help. I had an appointment last week for something, I phoned first thing in the morning to cancel as I had been vomiting all night and it was face to face; was told oh you have to leave your cancellation message with the designated answer machine we can't take cancellations over the phone even if they're late cancellations. Said okay fine, phoned and left a message, had a call a few hours later from a really annoyed doctor asking why I hadn't turned up. Said I have tried to cancel, done as advised and she said they don't have the staff to be checking the inbox more than a few times a week?! I get why she was annoyed so that's fine, but I'd spoken to a human, then gone by procedure and still wasted an appointment.

@user1497207191 If patients had direct access to specialists then what happens when specialist A washes his/her hands as it's not caused by their area, then same with Specialist B and C etc. Eventually these patients will have noone to turn to.
With increasingly complex patients, there is a need for a general view
I recall watching a TED talk about this a while ago where a relative described how each specialist looked after their own part of that patient's body but what the patient needed was a general doctor to put all the pieces together.

@SockQueen
It's probably not going to get any better now that hospital follow ups are being curtailed
amp.theguardian.com/society/2021/nov/25/plan-to-scrap-tens-of-millions-of-nhs-appointments-could-put-patients-at-risk

Easy.
Before they start medical school we maje them sign a contract that they have to pay back all the publuc money invested in their training if they go to work abroad.

@Bagamoyo1

OP you only have to spend 5 minutes on MN to see why GPs are leaving. Everyone hates us. I’m working harder than I’ve ever worked but it’s still not enough. I’m leaving as soon as I can.

We really don’t. 💐 It is sad that we have come to this.

@A8mint

Easy. Before they start medical school we maje them sign a contract that they have to pay back all the publuc money invested in their training if they go to work abroad.

Asking 18 year olds to sign binding contracts about something 5+ years into the future? Can't see what would go wrong with that...

And will we be asking all the doctors who've come to the UK from abroad to pay back their own countries' investments?

@A8mint
So would the UK government repay the government's of foreign doctors who work here?

@happydramatic

Hmmm. Some dubious information on this post.

DH is a GP. It's a horrible job. Less than 60k for 3 days a week, some days he works 8am-1am. Treated like a pretend doctor as not a specialist, 10 minute appointments, constantly extra patients or home visits squeezed in. It's impossible. If there were any financial alternative for him to quit he would. Possibly to retrain in A&E.

Yeah- big career mistake he would say.

Why does he work 3 days a week?

None of the doctors at my surgery works more than three days a week. It takes a month to get an appointment. Between my close friends and family this year we have had three misdiagnoses, two of which have only been correctly diagnosed having self-referred to a private specialist. Not weird stuff, just general health problems that should have been dealt with by the GP. In each case the GP dismissed the symptoms and didn’t listen.

I don’t know what it is but something’s going very wrong.

@SockQueen

Asking 18 year olds to sign binding contracts about something 5+ years into the future? Can't see what would go wrong with that...

Err...Most Uni students sign binding contracts to get student loans which take 30 years to pay back. Lost of trainees on training contracts sign contracts binding them to pay back costs of their training if they leave employment within certain period of time. It's entirely reasonable when huge amounts of money are being spent on their training/education.

@BoPeeple

None of the doctors at my surgery works more than three days a week. It takes a month to get an appointment. Between my close friends and family this year we have had three misdiagnoses, two of which have only been correctly diagnosed having self-referred to a private specialist. Not weird stuff, just general health problems that should have been dealt with by the GP. In each case the GP dismissed the symptoms and didn’t listen.

I don’t know what it is but something’s going very wrong.

There's been a growing trend for doctors to want to work "family friendly" hours for a couple of decades, particularly female GPs.

It's blindingly obvious that you need to train twice as many GPs if most only work half weeks, yet neither successive governments nor the BMA put in the place the additional medical schools/training places that were blindingly obviously going to be needed.

In fact the BMA voted to restrict places at medical schools and for a complete ban on new medical schools. www.bmj.com/content/337/bmj.a748

@A8mint

Easy. Before they start medical school we maje them sign a contract that they have to pay back all the publuc money invested in their training if they go to work abroad.

And I suppose we are going to reimburse the money other countries have spent on training healthcare staff we now employ?

@Tabbacus Funny that @user1497207191 isn't answering that question
Typical self entitled culture that's draining our public services imo
The idea that everyone has to be willing to give up their lives to serve me but I won't bother to put the effort / cost in

@ILoveAllRainbowsx

I don't think that we should recruit more GPs, I think that we need to totally change the system.

People want A&E and Urgent Care Centres 24 hours a day. We don't need GPs to refer us for treatment, lots of countries allow patients to refer themselves and it works fine.

We need specialist mental health practitioners dealing with mental health problems, not GPs.

We need to change the whole system. GP practices don't work.

We've less GPs, Nurses, MH specialists, AHP, Beds, Scanners etc than comparable EU countries.

The pandemic and brexit has highlighted this - look how our healthcare system has completely fallen apart, 6m (and growing) people waiting for hospital treatment.

Of course people need 24hr AE and Treatment centres, what on earth are you on about?

GPs need to refer for specialist treatments... imagine demanding to see a Neurologist, just because Dr Google told you that headache was in fact a Brain tumour.... the system would collapse.

The GP system is quite brilliant but like our hospitals, it cannot work unless it is funded/staffed to a sufficient level.