Role model: Mark PurvisBMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2806 (Published 13 June 2017) Cite this as: BMJ 2017;357:j2806
Anne Gulland speaks to Mark Purvis, director of postgraduate GP education and head of the school of primary care, Health Education England Yorkshire and the Humber
Telling the story of the defeat of the Spanish Armada at the hands of the plucky English might be a strange way of explaining the beauty of general practice, but it makes sense when Mark Purvis does it.
He remembers being spellbound at school as his history teacher described how the smaller English ships were able to outflank the lumbering Spanish galleons. The English crews were archetypal generalists, as they both sailed the boats and took up arms, whereas the Spanish crews were trained for just one role.
“I have always been enthused by the flexible, adaptable career of the generalist: the person who has multiple skills and who can do a large range of things,” he says. “It makes you nimbler and better at adapting to change.”
Purvis was born and brought up in Portsmouth, and he chose a vocational degree as it seemed like the most secure option. He studied at Leeds University and has remained in Yorkshire ever since. “Training is sticky,” he says.
He had dreams of becoming a GP version of the semi-fictional Yorkshire vet James Herriot, working in a country practice in the Dales. But he ended up taking a training post in the suburbs of Bradford, where he has remained ever since.
Purvis says that his trainees teach him as much as he teaches them. This view probably explains his move into teaching, although he says he was in the right place at the right time when both his trainer and then programme director retired. “Someone told me that you should have an interest outside general practice to get the balance right, so that’s why I got into teaching,” he says. “The balance has tipped me away from general practice as I only spend one day a week there.”
When he first started working in Bradford, all the training took place in suburban practices on the outskirts of the city, rather than in the centre. He changed this model when he became training programme director.
Purvis parachuted his “brightest and best” trainees into practices in the deprived part of the city. Now trainees divide their time between the better supported and the least supported practices. “If you spend half a week in a deprived practice and half a week in a better supported practice your behaviour is normalised to that of the supported practice,” he says.
Purvis says he is driven by dissatisfaction—that is, the notion that something can always be improved. However, he believes that the direction that general practice is going—into larger federations of practices—could also be its downfall. Continuity of care is what patients value—and that is at risk in the new model.
“The beauty of general practice is that it is embedded in its community,” he says. “Why do patients afford me the privilege of being able to sit in front of them when I don’t understand the first bit about their lives? Because the practice staff live, work, and shop in the same places and send their children to the same schools as our patients.”
He says some of his most valuable teachers have been patients. And this view of learning from others could also explain his passion outside of work. A keen amateur rugby player throughout his life, he became president of his local club when his playing career ended and he decided he wanted to give something back.
He became aware of an organisation called International Mixed Ability Sports and watched the world’s first mixed ability world cup rugby tournament—mixing players with disabilities with able bodied coaches and helpers—in 2015. The scales lifted from his eyes, he says. “This is a social intervention. In medicine we have a focus on disease intervention but we have to radically shift the focus around re-ablement and prevention,” he says.
He believes everyone in the health service should be aware of organisations such as these. “This is what inspires me now,” he says.
Nominated by Krishna Kasaraneni
“Mark Purvis is a passionate GP and educator, and cares about general practice—not just the way it used to be but how it should be, going forward. He works his socks off to support trainees and makes you want to stand up and do the right thing every time. He is always there for guidance and support and I could not say enough to explain why he is my hero.”
Krishna Kasaraneni is a GP trainee, Yorkshire and the Humber