No, your GP is not ‘just a doctor’

The first time I heard the phrase ‘just a doctor’ I was still in high school. Since I was 10 years old I had wanted to study medicine, and as the end of secondary school loomed it looked like my childhood dream could become a reality.

2017-05-13 GP Not Just A Doctor Featured Photo

When year 12 finally rolled around, I was inundated with questions about what I wanted to study at university. Naturally, medicine was my answer. After all the same old, ‘Wow! You need really good marks for that don’t you?’ Every so often the following statement would be added offhandedly, in that typical Australian style, to the end of our exchange. ‘So, do you want to be just a doctor, or…?’

The first few times I could only look a little confused and ask what they meant by such a statement, to which I soon learned unanimously referred to general practice. Once this was made clear to me I became more fervent in my defence of the GP. Although having never really considered this as the career path for me – being set on surgery for almost 12 years – I would clap back, maybe a little too shortly, with ‘you do realise that you don’t just graduate and ‘bam!’ you’re a GP? They complete specialist training too’.

To whomever my audience was at the time, this must have been a similar revelation to being told that the world was not in fact flat. Cue total and utter shock that the humble GP could ever be as specially trained as the plastic surgeon or the cardiologist. In the five years since I graduated high school I’ve been asked this question less and less, and had almost forgotten these exchanges ever occurred.

Recently, through a series of events, that tiny, irritating “just a doctor” comment came back to the forefront of my mind. You see, I started my GP rotation, and was thrown into the complex, difficult, unpredictable world of general practice. Completely overwhelmed and underqualified, I was given 8 patients to consult, with 45 minutes per patient – three times as long as your average GP.

To say I was a little tired by the end of my first day was an understatement. Coming home, doing study was the last thing on my mind. My social media newsfeed revealed a telling article written by Sydney GP Dr Elizabeth Oliver. The article, What I do for the $37.05 that no one wants to pay, was a seething condemnation of the inadequacy of the Medicare rebate for a standard GP consult, made worse by a society that all but compels GPs to bulk bill.

The beginning of the second paragraph made my blood boil; one of her patients, following a multiple-issue consult, left the room with the words ‘That was easy money for you, wasn’t it?’

The answer to that is no. Yes, medicine is like any other profession in that some days are easier than others. A patient presentation may be relatively straightforward or it may require a culmination of half a dozen ideas to formulate the most likely explanation. However, being a doctor is not ‘easy money’. It requires years – even decades – of training and specialisation, all in the pursuit of delivering the highest standard of medical care. And yes, that includes just over one-third of registered medical practitioners in this country that are so often referred to as ‘just a doctor’.

The GP is our first port of call for all things medical. Our health perhaps depends more on GPs than any other doctor (for the most part at least). Yet it’s GPs who bear the brunt of that phrase that’s as inane as it is offensive.

Brian is a dairy farmer. His nearest hospital is almost an hour’s drive away. After milking the cows in the morning he has some discomfort in his chest. He’s not worried, but his wife Mary is. She rings up ‘just a doctor’ and Brian is seen that afternoon. Brian has an ECG done and is found to have had a heart attack. He is taken by ambulance to hospital and given the necessary care by a specialist cardiologist. He survives.

Megan’s three year old daughter Eve comes down with a fever at day-care and is sent home. Megan isn’t too worried, her two older children have had similar illness to no great consequence. She’s a busy mum and doesn’t have time to sit for hours on end in the ED. She’ll probably be okay by morning, but the local GP usually has a cancellation when she rings and gets a last minute appointment. Whilst ‘just a doctor’ is examining Eve, he notices a rash beginning. He recommends Eve is taken straight to hospital and phones ahead to let them know. On arrival Eve is immediately seen by an emergency physician and – the relevant tests taken – hooked up to IV antibiotics for suspected meningitis. She survives.

Glenda has been having a hard time at work. The management has changed and her hours have been cut. She’s a single mum so money is pretty tight. She also has high blood pressure and needs a new script for her medication. She goes to her appointment and ‘just a doctor’ asks how things are at work. Not good. So bad actually that Glenda has thought that now she has nothing to live for and maybe it would be better if she just took a few extra sleeping tablets tonight before bed. In addition to her blood pressure script, Glenda is counselled, given some antidepressants and a follow up is organised for a week to have a mental health care plan done. She survives.

These three examples are just a tiny selection of the work of a GP, and without these doctors – who really are specialists – society would be very different indeed. The outcomes for Brian, Megan’s daughter, and Glenda might not have been so rosy.

Every day there is a group of people who would not seek medical advice for a seemingly minor issue if it weren’t for GPs. Sure, every day there is someone with a viral infection who wants antibiotics even if you assure them they will do nothing until you’re blue in the face. But, there is also someone who might not still be here today if it wasn’t for the astute and enquiring nature of the humble GP who asked just the right set of questions at just the right moment.

Even though general practice is probably not my calling and I may very well end up one of those (so-called) high-flying specialists that are so revered by the society we live in, if I do find myself as a GP in a decade’s time I would be incredibly proud to be ‘just a doctor’.

The views and opinions expressed in this article are those of the author and do not necessarily represent those of the Doctus Project.