A day in the life of Dr Jo Ratan

I became a fully qualified GP ("general practitioner" in the UK, "family physician" in the USA) in February this year, and after being a locum for a while, settled into a more permanent job at a practice in Long Eaton this June. I am not a partner, but a "salaried" GP, employed by the existing six partners to share the clinical work with them, the advantage for me being not having to buy into the practice or take any responsibility in the financial and legal aspects of running it.

I get into work about 8.30am with the aim of clearing some paperwork before surgery starts at 9am, then it's off on the rollercoaster that is General Practice. There are 10 minutes per appointment, which is insufficient for most problems, so I frequently overrun. I have a timetabled break for coffee about 10.30am and always try to escape my consulting room, which can feel intense after being alone in there with patients all morning. The only problem is that the patients in the waiting room can see me going upstairs to the kitchen, which never goes down well... doctors aren't supposed to take breaks, are they? It's therapeutic to bump into one of the other doctors, a nurse or a receptionist for a laugh or some chat before re-immersing myself in the problems of Long Eaton. Surgery finishes around 12pm, sometimes later if there are emergencies to see at the end, then there's often a visit to do and always blood results to look at and more paperwork. Afternoon surgery for me starts again at 2pm, then it's a 3 hour surgery until 5pm, though there's usually more paperwork to do so I don't usually leave until well after 6pm.

My "on-call" day is usually more colourful, as I take all the calls for home visit requests, give emergency telephone advice and deal with any problems that health visitors, district nurses and anyone else vaguely involved in healthcare may encounter with our patients. This has recently involved sectioning someone under the Mental Health Act, advising the Police about a persistently drunk patient who rings 999 everyday and advising the mother of a child who managed to get bitten by a squirrel...

So, what do I give in General Practice? Well, prescriptions, sick notes and advice in abundance and occasionally injections. A lot of what I give isn't welcome... advice on needing to lose weight (particularly unpopular), stop smoking and cut down on alcohol. Also bad news; about a diagnosis, or perhaps the news that it's time to come off a particular drug or get back to work... Often I'm not sure what I can give to people, who come with such insoluble personal and social problems. The other day it was a lady with a list of physical symptoms who also added "Doctor, my husband works long hours, I'm worried about my children and I have to look after my granddaughter for most of the time... and I'm afraid of getting old..." It's at times like this that I'm an independent pair of listening ears in a world where most people are too busy to listen. I 'm not there to judge, but to have ideas and suggestions bounced off me... I can reassure grieving people that it's ok to feel rubbish and tell the relative of a patient just diagnosed with cancer that it's normal not to cope... I can't give people on benefits any money nor solve the problems of a woman being beaten by her husband, but I can advise, encourage and try to empower people to help themselves.

On the flip side I take plenty as it's undoubtedly a rewarding job, and although I complain about many things, the variety I encounter in General Practice ensures that boredom it not one of them!

Jo Ratan

St Peter's Church, Nottingham
Last revised 6th November 2003