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Saturday 1 October 2016
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Is it late in the day for general practice?

Well, I'm a seasoned professional now when it comes to the extended hours surgeries. I've done one a week for the last two weeks. A very pleasant way to avoid putting the children to bed at home. Spot the heavy sense of sarcasm.

The first surgery took a number of surreal turns. My last patient arrived with the opening gambit, "You should be at home with your family", and ended with, "I can't understand people coming to surgery in the evening" as he shut the door at 7.35pm. I wonder if he was operating on New York time.

It all seems fun and appealing, a bit like visiting a supermarket at 2am. Unfortunately, like the 2am supermarket visit, once the novelty's worn off it seems much more sensible to go during the day (especially as prescriptions given during our evening surgery are invariably going to be cashed in the next day).

My scenarios for the reception away day are complete. I have six scenarios that we will run for the receptionists to comment on. These range from dealing with foreign patients (no mention of the Lisbon Treaty) to how to handle an unbooked patient knocking on the door during an extended hours surgery (we shouldn't hide under tables).

I've roped in one of my partners to help with the role plays. He is going to dress up in a receptionist's uniform. He didn't need too much encouragement.

We've advertised for new salaried doctors in recent weeks and had a tremendous response. The interviews are almost upon us. I've been overlooked for the interviewing panel, possibly because l could be a loose cannon when it comes to questions. Amazing how few know who the Secretary of State for Health is …

I think the applicants' sickness record is important after our experience recently. I'm also not sure of people who talk of work/life balance at interviews. Is it too cynical/ hardnosed of me to suspect those who say this are really thinking about their annual leave entitlement?

I dreamt last night that our surgery was taken over by a well-known supermarket. It wasn't so bad, though my salary was paid in tokens redeemable at the checkout, each patient had to be offered a "2 for 1" deal and my pension was paid in trolley-loads of tomatoes (at least my prostate was saved).

There's so much uncertainty – in the year the NHS turned 60 – that this may be the end of primary care forever, and I fear that GPs and primary care in general could go the way of dentistry in this country.

Oh well, my next extended hours session is booked. The average age of the patients who will attend is 75; that'll be all the workers on their way home from B&Q.