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

Wendy Burton

20/08/2019 3:29:17 PM

Dr Wendy Burton reflects on wearing the label ‘Just a GP’ with pride, and how it helps reinforce the love of her profession.

Dr Wendy Burton
Dr Wendy Burton was inspired by the positive response to her proud deceleration using the #JustAGP hashtag.

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

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Mike Ellis   21/08/2019 6:48:54 AM

Inspirational Wendy,
I too have been a GP for over 30 years and often despair at the A&E attitude of many of my registrars. We are the conductors of the medical orchestra and without us all you had is a lot of noise and no satisfactory outcome.

Craig Lilienthal   21/08/2019 7:09:13 AM

I prefer “Are you a GP or just a specialist?”

Dr Genevieve Yates   21/08/2019 7:57:18 AM

You've encapsulated the essence of general practice beautifully, Wendy. What a shining example you are to our profession. If only more GPs were "just" like you :-)

Oliver Frank   21/08/2019 8:04:10 AM

Very well said!

Dr Elysia   21/08/2019 8:20:20 AM

Great Article!

Ayodele Ogunjobi   21/08/2019 8:44:43 AM

GPs are not just a GP but a Specialist GP. Let's stop demeaning the profession of a GP. No Cardiologist, Neurologist and Urologist etc will add just in front of his title. It ok to say I am GP but to add just is demeaning.

Danny B   21/08/2019 9:14:20 AM

So well written Wendy. Thanks for sharing your stories and insights.

Amila Munasinghe   21/08/2019 9:47:48 AM

Well written Wendy. We all have similar experiences but you have put it into words nicely. Can I steal your T Shirt print please.

Louise Edwards   21/08/2019 3:02:22 PM

Great description of a career that continues to fascinate and challenge me, and with rewards that are beyond measure. In the Renaissance historical period, it was breadth of knowledge and skill that was cultivated over depth- and look at the example provided in the diverse interests and life achievements of Leonardo Da Vinci! GP is a true Renaissance Specialty - lets continue to be inspired by our chosen Specialty with joyful anticipation for the future .

Mainul Hossian   21/08/2019 3:51:05 PM

Well articulated piece about our great profession an we should all be thankful, not proud, that we have the opportunity to make some positive change for our patients. I sometimes tell my patients that life is a little bridge. We all have to cross that bridge, but at some stage, we don't know when, we have to get off this bridge. We don't get permanent residency here. As a GP or a doctor, all that I am doing is, trying to make sure that my patients get the best business class seat when they are travelling through this bridge.
Thank you for your great article.

Dr Paul   21/08/2019 6:40:42 PM

Oh, come on now! Bit of a holier than thou attitude, methinks. We are all different (thank goodness!) and it’s no crime to enjoy “in-out” script time on occasions #itsonlyajob

Dr Gwendoline Ruth Burton   21/08/2019 7:42:13 PM

Amila, Wendy here. Yes, you can use the quote for a T-shirt, but do make it your own. Antenatal visits and toddlers with colds do go together, but what have you done/do you do as well? Discuss dad's depression? Manage anxiety? Biopsy skin lesion? This tweet came from an actual consultation. Make it your own!

Tyson   22/08/2019 9:14:31 PM

Whilst I would love to embrace this article and say well done I only feel it highlights a problem rather than solves it. The tokenism other specialists give to us saying we “do the hardest job in medicine” is not backed by professional attitudes. This is reflected in medicare rebates. Society does not value the service of General Practice and neither does our Government so young Doctors please choose another specialty and call yourself a specialist with pride. #overGP

Karen Magraith   24/08/2019 6:09:31 PM

Excellent article. An ongoing problem to be solved is how to promote the quality practice described. I have learned to ignore the negative associations with being 'just' a GP, but there is a long way to go to improve our standing in the general and medical communities.

A.Prof Christopher David Hogan   26/08/2019 6:50:48 PM

We can be our own worst enemies
We lock ourselves away in our rooms & work one on one with our patients Who do we compare ourselves with ? ......... Perfection.. but none of us can attain that.
I have been very fortunate as a coal face GP, as a teacher & lecturer & as a researcher to see many GPs in action- they are superb>.
Who has the best results in smoking cessation ? - GPs
Who deals with almost 90% of all high incidence mental illness? - GPs
Who deals with most diabetes, asthma, COPD, arthritis etc?- GPs
I am also fortunate to have worked in hospital teams, university teams, disaster teams etc
Who are the experts?- GPs
When we do our jobs perfectly - no one sees it, expect the patients.
Who sees our failures? just about everyone but no one recognises this selection bias except us !
We need to return to the prevocational treatment program whereby PGY2 & PGY3 doctors all spend time in General Practice. So often many were inspired to become GPs or realise how hard it is