Why I Resigned from My Job as a GP

Dr Vernon Coleman MB ChB DSc FRSA

During the 1970s, I worked as a GP. It was the job Iíd always wanted to do and one that I enjoyed a great deal.

In those distant days, GPs were responsible for their patients 365 days a year and 24 hours a day. So that we had some time off, most doctors worked in informal groups of four or five. Often the association was a very loose one in that individual GPs ran their practices independently and merely shared their out of hours responsibilities. It all worked surprisingly well and easily.

If there were five doctors sharing their night time, weekend and bank holiday calls then each one of the five would be on call one night a week and one weekend in five. It wasnít particularly onerous.

At the end of the day a doctor who was looking after a patient with a specific problem would ring the doctor due to be on call and tell him if he was likely to be called out. `Mrs X has a bad chest infection but I think she is responding to the antibiotics. If her husband calls, you may have to fix a hospital bed for her.í That sort of thing.

I never particularly minded out of hours calls. Indeed, the best bit of being a GP was driving back home at 4.00 a.m. having spent an hour or two treating a patient at home. It might have been an asthmatic having severe trouble breathing and needing intravenous injections. Or a child screaming with pain from an ear infection.

Of course, the glow of satisfaction might dim slightly if, when getting back home, I found there was another call to be done. If there was then it would inevitably be to a house in the next street to the one Iíd just left. There were no mobile phones those days, of course.

After a night on call we still did morning surgery, of course. And that was sometimes a little tiring. I wasnít the only GP to fall asleep in his consulting room.

So why, after just ten years, did I give up my dream job?

It was the paperwork, the bureaucracy, which defeated me.

One of a GPís tasks was to sign sick notes. And the law required doctors to put the diagnosis on the form. The patient then took the form to their employer. Inevitably, this meant that everyone in the office knew what the patientís problem was.

One of my patients was the manager of the local branch of a big chain store.

He came in to see me one day and it wasnít difficult to see the problem. He was severely depressed; worn down by demanding bosses and a difficult job. He needed time off work.

I reached for the sick note pad, scribbled his name and address and then wrote `depressioní in the box requiring a diagnosis.

`Do you have to put that down?í he asked.

I looked at him, puzzled.

`If my bosses see that then Iíll be fired,í he told me.

I ripped up the form and wrote another. On this one I scribbled `virus infectioní.

A couple of days a later a young woman came to see me. She was pregnant and was suffering from morning sickness.

`Do you mind not putting down that Iím pregnant?í she asked. `The girls at work donít know but I have to hand the form in to my boss.í

And so she had a virus infection too.

After that, all the sick notes I signed contained the same diagnosis: virus infection.

After a few weeks of this I was hauled before a local NHS committee. They had a sheaf of sick notes I had signed. All the forms had the same diagnosis.

To cut a long story short they fined me a couple of hundred quid and threatened to do it again and again if I didnít write down proper diagnoses. £200 was a lot of money in those days.

So I resigned from my job as a GP and became a professional writer.

Shortly afterwards, the rules were changed and patients were allowed to write their own sick notes.

Thatís the truth.

Bet you wonít read all that on Wikipedia.

Copyright Vernon Coleman May 8th 2020

While I was a GP I wrote three books about a GP. I wrote them under the name Edward Vernon. The titles were Practice Makes Perfect, Practise What You Preach and Getting Into Practice. Nearly fifty years later they are, Iím pleased to say, still hugely popular.