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As promised a short dissertation on why General Practice is worthwhile, response by 7/9/96?? The political and social changes in Britain in the 1990's and the effect of three conservative governments has totally changed the practice of medicine, in secondary care as well as primary care. We cannot pretend that we are alone in our discontent with the system. The economics of medicine are now a major player in decision making whether we like it or not. Most of the unhapiness in General Practice stems from the results of these changes. We feel overworked, under pressure and underpaid. The fundamental job we do has not changed, however, and it is this that is most important. It is the day to day contact with real people who need our help/advice/support that makes it worthwhile. There are in effect very few things we can cure, many things that we do not understand and unfortunately, many things that we know could be done better with better resources. The simple pleasures of improving the condition of ones fellow human beings and their resulting gratitude overrides the frustration and dissapointments engendered by the changing circumstances. We mostly entered into this strange profession because of the contact with people and their problems. The intelectual stimulation of the endless possibilities of what might happen next only adds to the positive side of primary care. The patients and their problems are the thing that is most interesting and satisfying about medicine, they are still the same even if the working enviroment has changed beyond recognition. One of the major problems that we have faced, and to a great extent overcome, is the change itself. Most GP's now have a better idea of the commisioning process and many will be greatly empowered by the ability to influence the direction of health care provision. We are turning the corner, I feel, and to give up at this point would be to throw away the best system of Primary Health Care in the world. The next few years will see further change in the mechanisms of health care provision, but not on the scale that we have seen before. The fall in GP recruitment and the loss from the profession of experienced GP's through ill health and early retirement will cause many problems, but can only serve to strengthen our hand in negotiating better terms and conditions of employment with the government. It is very easy to list all the things that are wrong with our situation. We must look at the changes as a necessary evil ( like most doctors look at their computers) and build on the trust and confidence the vast majority if our patients have in us as healers, to allow us to continue serving them. Trefor Roscoe Email; [log in to unmask] Beighton Health Centre Tel 0114 - 269 5061 Queens Road, Beighon Fax 0114 - 269 7186 Sheffield S19 6BJ %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%