Something all GPs are aware of, and it looks as if the shortage of GPs in training allied with the early retirees and leavers mean GPs will become rare as hen’s teeth. This is good news and we should spend elsewhere… and ration screening out wherever it is questionable… How about mammography and cervical smears being paid for at cost by all except those on benefits?
Paul Myers describes our skills as “skilled diagnostic assessment and holistic management of multifactorial and undifferentiated problems” (RCGP Wales Update newsletter: Message from the Chair). He is correct: an accurate diagnosis in physical, social and psychological terms was the old parlance, but as populations get older they get many diseases in the one person; hence the complexity. Any time spent on doing other than diagnostic assessment should always be questioned – and chronic disease management, the cost of which accounts for much of the expenditure on GP, could be reduced by divesting this aspect in simple cases.