Through the eyes of a locum: The great escape

Dr Euan Lawson, a locum GP from Cumbria, explains why every GP, including locums, should have an open door when not consulting.

Many GPs are contemplating their future and hatching their plan for their own great escape. We’ve been battling hard but GPs are now more like beleaguered prisoners of war than enthusiastic combatants. It can be a lonely business and the worry is that a few will go stir crazy.

One sweltering summer I did a locum for several weeks in a practice that tested my resolve. Sat in my hot box it was more Bridge on the River Kwai than Colditz. Sometimes general practice leaves me feeling like Alec Guinness’s confused colonel, dazed by the heat, trying to do the best for my men while we all build a bridge for the enemy. That film finishes on the medical officer and his sweaty, anguished face. “Madness. Madness!” indeed. He could have been gazing on the modern NHS.

That summer, the computer told me there were half a dozen GPs in the building – but it was the only clue to their existence. All I saw were the closed doors. I don’t know if they regarded locums as the enemy but they certainly weren’t fraternising. It was the kind of practice that scheduled patients for the locum on prescribing while the regular GPs had a coffee break. There are times when working as a GP can feel like doing time in solitary. In the cooler, Steve McQueen style. Only it’s worse as you don’t even get the peace and quiet of actually being on your own.

Every GP should prop open their door when not consulting – it may result in the occasional request to sign a script but the actual human contact that results is worth it

Yet just two things are needed to dispel the loneliness of general practice: door wedges and a NAAFI break. Forget the escape plan. There is no need to smash up the common room table to shore up the tunnels. No walking around on visits shaking your legs to disperse the freshly dug soil.

Every GP should prop open their door when not consulting – it may result in the occasional request to sign a script but the actual human contact that results is worth it.

The NAAFI break is observed with near religious conviction in the forces. And for good reason – tea breaks are a chance to share stories and experiences. Careless talk may cost lives, but, in this case, gossip will save us. And don’t forget to invite the locum.