We're proud of who we are

One of the College’s Position Statements reads:

Every person should have a general practitioner.
There is a need for the continuing role of general practitioners specialising as generalists.

A GP is an appropriately qualified and registered medical professional, with knowledge and skills to provide personal, family, whanau, and community orientated comprehensive general practice care that:

• Continues over time
• Is anticipatory as well as responsive, and
• Is enhanced rather than limited by the age, sex, race religion or social circumstances of patients, nor by their physical or mental states.

I know what a General Practitioner is and I suspect most of you know what one is too, especially those of you who are vocationally registered and entitled to practice independently.

But many other people seem to have a problem in identifying one. They reckon a Surgeon is easy to recognise, likewise a Dermatologist or an Ophthalmologist. However that is probably only really applicable to the urban centres – look round your Rural hospital and it all gets rather fuzzy. There is however a tendency to blur anyone working outside a hospital in some sort of open access or self referral clinic as a GP.

We also have the worrying situation of doctors calling themselves general practitioners being allowed to provide general practice services without any general practice training. How has this been allowed to happen? You can’t call yourself a surgeon and start operating. The reason you cannot is quite correctly to protect the public from unqualified doctors carrying out operations. An excellent reason; so why are the public allowed to have general practice services provided by similarly untrained doctors?

In February the Deputy Health and Disability Commissioner published her findings following a complaint about the care a woman’s late husband had received from what her report says were “several general practitioners”. This was a case of a patient with an ongoing sore throat and difficulty swallowing that eventually turned out to be a fatal lymphoma. He presented to five “general practitioners” before his condition was correctly identified. The press picked up on the story as well although the headlines varied in their description of the health professionals as either doctors or general practitioners.

I am often contacted by the media for comment on matters that allegedly involve a GP. The first thing I do when asked to comment on what a GP is or is not supposed to have done is to have a quick look at the College membership list and the Medical Council website. Often I find the doctor involved is not a GP at all. Exactly what sort of doctor they are is often not clear but as the president of the College of GPs should I be even commenting? At times I fell I am waging a crusade on behalf of GPs. Don Quixote maybe? Now Don Quixote is one of the most famous and famously unread books in the world – up there with Stephen Hawking’s “A brief history of time”. The first half of Don Quixote is completely farcical but the second half is serious and philosophical on the theme of deception.

In the H & D C case I referred to earlier, three of the doctors were not GPs at all – by that I mean they were not College members and were not engaged in AVE or doing MOPS. Of the remaining two, one was the patient’s usual GP and one was a Vocationally Registered AMPA doctor.

So sometimes GPs are identified by what they are not rather than what they are. In the College we are very clear as to what a GP is and we stick by our definition.

From time to time proposals to change our name are made. A recent proposal was published in the College journal [New Zealand Family Physician!] suggesting we call ourselves Primary Care Specialists. This was to better define our role and give recognition to our higher training and skills.

I ran that name, plus Family Physician and General Practitioner through Google and got the following results: General Practitioner 24.9 million results, Family Physician 4.1 million and Primary Care Specialist 13,900 only. Why should we change our name because others have hijacked it? Did the Hilton Hotels change their name because some small hotel in the South Island used their name? Not likely – they threatened dire legal consequences instead!

We need to be proud of the name General Practitioner and hold it very close and very dear. We should only allow it to be used for those true General Practitioners i.e. Vocationally Registered GPs or registrars and senior registrars in the General Practice Education Programme.

We are the Royal New Zealand College of General Practitioners and we’re proud of who we are.