Looking After You Too Case Study: Salaried GP – newly qualified

Role and Context

The Salaried GP is a newly qualified part-time GP who has been in their current role for 18 months. They work for two days a week at a practice based in West Yorkshire, serving a predominantly rural, low socioeconomic status community. They worked in the same practice for a year as part of their GP training.

Before the Covid-19 pandemic, the GP’s workload involved approximately 30 in person appointments, two home visits and a couple of telephone consultations each day. In March 2020 with the introduction of lockdown, the practice’s whole appointment structure changed. Patient consultations were conducted over the telephone as a default and patients were triaged according to need. The practice is part of the local primary care network of five practices and operated as a ‘red hub’, seeing patients one day per week.

Challenge of Covid-19 on own wellbeing

The impact that Covid-19 was having on practice staff was significant. Levels of staff sickness absence increased, with staff experiencing both mental and physical ill-health. There was a period when many staff contracted Covid-19 and the GP described how “Covid basically took down the whole surgery, we all got it”.

However, it was the emotional impact of dealing with the pandemic that they recall most vividly. Initially, they found the uncertainty very challenging and working in the red hub was “quite frightening” as not much was known about Covid and how it would affect people, so the staff were exposing themselves to unknown risks.

“It was very challenging to start off with, it was all very different and very uncertain. We didn’t know what was going to happen.”

Throughout the pandemic, the GP mentioned that their mood was “up and down” as they struggled to deal with the challenges that the pandemic brought. They commented that it was difficult seeing everyone in the general population so sheltered: going to work became scary. As a GP, they were used to supporting other people and did not always consider their own wellbeing, acknowledging that at times the experience “was really anxiety provoking”.

How Looking After You Too coaching helped

To help maintain their wellbeing, the GP had previously used wellbeing apps and they had a very supportive social network with whom they discussed non-medical work issues. They heard about the coaching service through a forum for newly qualified GPs and accessed it after ‘a dip’ in their wellbeing in early 2021, following the introduction of a winter lockdown.

The coaching helped them to step back and reflect more rationally about their workload and the impact that it was having on them and their family. They realised that they were feeling guilty about working as well as feeling guilty about not working.  Through this time of reflection with the coach, they had worked on developing a more positive focussed attitude and working practices.

“A lot of the stuff was conversations that we had about stepping back and taking an overview and not feeling guilty about certain things and looking at the value of the work that I was doing.” 

The GP found their coach “really easy to talk to” and, in the sessions, they discussed what was making them feel anxious and what tools or techniques could help. The coach gave them lots of practical advice, such as encouraging them to articulate to colleagues how they were feeling during negotiations about workload and making sure that colleagues understood the emotional toll that work was having on them.  This helped them to express their opinions clearly, reducing their anxiety and avoiding potential conflict situations.

The GP was experiencing anxiety before their Monday afternoon shifts and sometimes found themself working in advance of their hours to reduce this anxiety. After discussing this with their coach, they changed their working pattern to start earlier in the day, preventing themself from working additional. They also realised that they were overcommitting themself, working several extra Covid clinics, and following the coaching has negotiated fewer shifts.

Impact of the coaching

“It was about me making my own changes and how to go about that and give me the confidence to do that.”

Although they recognised that there is a danger that they could “flip back” into old ways, the GP feels that the coach has enabled them to think differently. They no longer feel guilty about working part time and spending time with their family or on their own. “I’d always had felt guilty if I had time on my own, but I think I do need that time.”

The GP found the five coaching sessions helpful in managing their work-life-balance. In the last month, they had been offered a lot of extra work, which they would have previously accepted but, because of the coaching, they felt they could negotiate their working hours and can say ‘no’ to extra work, feeling more comfortable with the decisions that they have made.