We need to redefine ‘full time’ and ‘a session’

[摘要] Shemtob et al’s interesting article highlights that ‘full time’ is widely used in a misleading way in relation to GPs.1 We need to stop defining full time as ‘10 sessions per week’, and, if we do still want to talk in terms of sessions, we need to acknowledge that, in my experience, a session stopped meaning 3.5 hours of work about 20 years ago.Instead, I suggest defining a session as the time it takes to see 16 patients (or speak to them remotely; we need to drop the idea that telephone or video consultations are generally shorter than face-to-face ones, unless talking just about telephone triage), and to do any admin that the consultations require, including making referrals and acting upon the letters and results that come back. Some of these actions, such as communicating with patients, discussions with colleagues, prescribing new or altered medication regimens, and planning next steps, obviously take place another day, but each 16 patients will generate admin work for a future session as well as the on-the-day admin, so such follow-up work can be counted within ‘a session’.This definition excludes any time for home visits, because I gather that many GPs no longer do these regularly, instead delegating them to other clinicians.Throughout the second half of my 33 years in practice, it took me at least 5 hours to deal adequately with 16 patients: 4 hours’-worth of 15-minute appointments followed by an hour of patient-related admin. Those 5 hours exclude management and teaching work and continuing professional development (CPD), let alone lunch.So a full-time GP is one who does seven clinical sessions per week plus some teaching, CPD, and audit, and has the occasional coffee break to debrief with colleagues. To achieve their stated aim of encouraging ‘an accurate portrayal of general practice’, Shemtob et al should answer their own question far more assertively: ‘10 sessions of clinical general practice’ is not ‘doable’, and definitely not sustainable.© British Journal of General Practice 2023REFERENCE 1.↵Shemtob L, Driessen J, Howe A, et al. (2023) Notes for a profession in difficulty. Br J Gen Pract, DOI: https://doi.org/10.3399/bjgp23X733041.

[学科分类] 卫生学