Helen Salisbury: Rebranding our experts in family medicineBMJ 2023; 381 doi: https://doi.org/10.1136/bmj.p1229 (Published 30 May 2023) Cite this as: BMJ 2023;381:p1229
- Helen Salisbury, GP
Follow Helen on Twitter: @HelenRSalisbury
What is a GP? I suspect that if you asked a representative sample of people on the street, some might be unsure what the initials stood for, but nearly everyone would know that a GP is a local family doctor, the one they go to first with a health problem. Ideally, they’d associate the idea of a GP with someone familiar, an expert they already know and trust.
The recent conference of UK local medical committees passed a motion calling for GPs to be rebranded as “consultants in family medicine” and for the General Medical Council’s GP register to be merged with the specialist register.1 I understand the feelings that drove this vote. A common grumble among GPs is that our expertise isn’t valued, despite our specialist skills in looking after whole families and managing complexity, multimorbidity, and polypharmacy. In recent years some GPs have been busy supervising allied health professionals and leading multidisciplinary teams, which has similarities to the way hospital consultants work and is a departure from traditional general practice.
Any desire for change is also about respect. I suspect that some of my colleagues hope that a rebranding as consultants might stop the un-resourced transfer of work from hospitals to GPs, which often makes us feel as though we’re being treated like junior doctors. It makes sense to merge the registers as a sign of parity of esteem and a recognition that our training equips us to be expert generalists.
For our patients, however, any change of job title would cause confusion and involve a further loss of the familiar, when many are already mourning the closure of their local surgery (474 disappeared from 2015 to 2022).2 We need to ask ourselves whose opinion really matters. For most of the public, a “real” doctor is already the GP at the end of their street, rather than the remote consultant they meet only if they need to go to hospital. We don’t need to impress them with a new title.
We may be tired of the perception within medical circles that we’ve become “just a GP.” I’ve witnessed some interesting cognitive dissonance when a consultant simultaneously seems to believe that GPs have opted for a lesser career while admitting that they themselves would find the job impossibly challenging. Open disrespect for GPs is still sometimes heard in hospitals and is cited as a factor in junior doctors’ career choices.3 But I’m not convinced that changing our title would solve any of this.
If we do want to choose a new name, it should be one that’s easily understood by patients. It might contain the words family, community, or local, as well as doctor—but we should avoid the less familiar “consultant.” We should rightly celebrate our expertise, but we should then focus our energies on finding ways of working that improve continuity and make it possible to practise good family medicine.
Competing interests: See www.bmj.com/about-bmj/freelance-contributors
Provenance and peer review: Commissioned; not externally peer reviewed.