Enriching Careers in General Practice New roles for general practitioners

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Abstract
General practice is likely to change greatly over the next few years. Increases in care in the community and day surgery will lead to more work, and the demand for better data on practice activity will mean the development of audit and epidemiological work. To make time general practitioners will have to learn to delegate work that does not require a doctor. Fundholding has already stimulated some practices to bring services to patients rather than send patients to hospital, and this trend seems set to continue. It is important to pool resources, not only within practices but among other practices in the area - joint action will increase the ability to improve the services for patients. If general practitioners take the opportunity to gain control of the changes the morale of the profession should improve. The work of general practitioners has not changed greatly over the years. Fewer home visits are made now than previously, but the pattern of morning surgery followed by visits, paperwork, and evening surgery has endured for many years. Such familiarity has benefits but also threatens to stifle innovation. The financial security and tenure of general practitioners offers no incentive for progress1 but despite this innovations have been and continue to be made. This article looks at evolving aspects of practice and their implications. The new roles I shall consider are the general physician in the community, the epidemiologist, the entrepreneur, the networker, and the defensive general practitioner. The general physician in hospital practice is a thing of the past.2 Higher training as a senior registrar produces an expert in a narrow field, and general experience is not likely to increase by shortening specialist training as outlined in the Calman report.3 General practitioners who offer fewer services make more complaints about the number …