Am I ‘Just a GP’? Absolutely – and proud of it

On 8 September 2016, Dr Paddy Mosse put the call out on a closed Facebook group for members to start a Twitter storm the following day, sharing stories from the frontline using the hashtag #JustAGP. 
 
This followed a number of conversations we had been having about the role of GPs and how, too often, we would hear the term ‘Just a GP’ used in a derogatory sense. 
 
‘What the heck,’ I thought. ‘I may be a Twitter novice, but I’m in.’
 
The first tweet I sent read: ‘Antenatal visit. Tick. Check toddler with cold. Tick. Discuss grandad’s prostate cancer. Tick. One visit. Sigh, but tick. #JustAGP’
 
That tweet encapsulated for me what it is so good about being a GP – the intergenerational, cross-disciplinary role we play in a patient’s life is one only a GP can do.
 
The reaction on Twitter to the flood of #JustAGP posts from around the country – and, indeed, the world – was extraordinary.
 
At one stage, we were trending number six on Twitter.
 
It was really inspiring that so many colleagues joined in, and great to see support from other medical colleges, organisations and professionals and from the general public.
 
It also really confirmed for me how many amazing GPs are out there doing incredible work.
 
It didn’t restore my faith in general practice, because my faith was never gone, but it must be said that now and then colleagues fail to live up to your expectations. They treat a consultation like a 10-minute visit to the emergency department and you think, ‘Oh my gosh, is this where the profession is going?’
 
To see so many members of my profession step up and say, ‘No. There is a higher standard; general practice is more than a job, it’s a calling. We are GPs and proud of it’, was fantastic. 
 
It helped me push back against some of the negative feedback I hear about my GP colleagues and to argue with renewed conviction that it’s not just me trying to work to the top of my licence.
 
I was so inspired by the momentum of the day that I had a t-shirt made of my first tweet, which I wore to GP17, GP18 and RDAQ18, where it attracted positive attention and started a number of conversations.
 
Instead of accepting the phrase ‘Just a GP’ as derogatory, I’m owning it and wearing it as a badge of pride.
 
In effect, I’m saying, ‘Sure, I’m “Just a GP”, but have you checked out how awesome it is to be a GP?’


Dr Burton had her initial tweet printed on a t-shirt – starting a number of conversations at general practice conferences.

When I use the term ‘Just a GP’, it encompasses so many things I love about my profession.
 
One is the whole concept of breadth. It’s that, as a GP, I cover a whole lot of everything; obviously not to the depth that a sub-specialist does but, then again, that’s not my role.
 
When I need to, I can always phone someone or look it up or refer, but for me, being a GP is about knowing a lot about a lot, as well as a little about certain other things.
 
It’s also about the whole continuum and not seeing the individual as ‘an asthmatic’ or ‘a diabetic’ or someone with psoriasis, anxiety, PTSD or a personality disorder.
 
Instead, it’s understanding that each patient brings all those little bits and pieces into the consulting room. But they are them, they are the whole.
 
One of my frustrations is when a specialist tweaks a patient’s medication without consideration of the unintended effects this may have.
 
For example, a cardiologist took one of my patients off an antipsychotic because of a rare but potentially important effect on cardiac status.
 
But that doctor wasn’t there when the patient went completely psychotic, the family was at breaking point, and we had to bring the patient ‘back from hell’ (to quote my patient).
 
Such specialists are looking at patients through their own lens, but you can’t do that because people don’t come segmented – they’re a whole, and being a GP allows me to see patients as such.
 
The other part I love about being ‘Just a GP’ is that it’s not about a 15-minute appointment or a one-off thing. It’s about a journey and my commitment to be a person’s doctor. I’m in this for the long term.
 
I say to my patients, ‘When I retire, I want to be able to hand you over in good nick. So we’re going to work together on modifiable risk factors, and see if we can get you as healthy as possible, for as long as possible’.
 
The buck stops with me. I am their doctor and together we will work out what is happening or what we can do, even when there are no clear answers.
 
Being ‘Just a GP’ is also about the puzzle.
 
To me, the art and science of general practice, and medicine in general, is assembling a jigsaw puzzle when you’ve never seen the final picture.
 
Once you’ve seen the final picture the blue is obviously the blue of the sky. But when you’re looking at that blue without the final picture, it could be a dress, or a flower, or an eye.
 
So you need to put all the pieces together to make sense of it, and sometimes that’s complicated.
 
On a side note, here’s where, when we take bits off, sometimes the important are missing. That can happen if the pharmacist is looking after the patient’s UTI, or when the physiotherapist is the first port of call for the muscle aches and pains.
 
Then the risk is that I’m assembling the jigsaw all wrong because I don’t understand that those muscle aches and pains could actually be part of an autoimmune phenomenon, and that explains some of the problems my patient is having with her eyes.
 
So being ‘Just a GP’ means I’m an anchoring part of a patient’s journey, that I do a bit of everything, that I’m in it for the long-haul and that I have a ‘whole-of-life, whole-person’ view.
 
It’s about shared decision-making, always learning, and loving that process.
 
I’m not saying I’ll be the one that always makes the definitive diagnosis of a weird condition, but I’ll be the one that says, ‘I think you really need to see specialist X because my Spidey sense is tingling’, or, ‘I need help for this part of the puzzle’.
 
I don’t promise my patients that I have all the answers, because I don’t.
 
But I do promise that I’ll listen to them and learn with them and that I’ll be a detective and try to work out what is going on. 
 
So, am I ‘Just a GP’? Absolutely.
 
And proud of it.

generalist GP Just a GP