'If I could tell patients one thing...': GP on salaries, mental health and four ingredients that beat a cold

If you've ever spent your morning commute daydreaming about starting afresh with your career, this feature is for you. Each Monday, we speak to someone from a different profession to discover what it's really like. Today we speak to Dr George Hawche, a GP at the Fulham Medical Centre in west London...

A salaried GP working full time can expect to earn... anywhere between £80,000-£95,000, with GP partners often earning more. Locum or self-employed GPs can earn anywhere between £60 and £110 an hour.

NHS pension contributions are comprised of... 12.5% employee contributions and 23.7% employer contributions. As a self-employed GP partner, I pay both employee and employer contributions.

I think the work I do is fairly remunerated but... resident doctors are not paid fairly at all. Young doctors are now qualifying with huge debts and will be paying their loans back at extortionate rates for decades, so their starting salary needs to take that into account.

I always worry about making a mistake... It's people's lives in my hands, but I mitigate this by making sure I ask the right questions to each patient, understand exactly what they have come in with, rule out red flag symptoms and signs, and strongly safety net them so that if their symptoms change or develop, they know they can return for reassessment.

My biggest lessons have been to adapt my communication style... more readily, take my time a little bit more and ask for help and feedback from colleagues in a multidisciplinary team setting.

There's no truth in old wives' tales... When feeling unwell, it's really important to hydrate well, rest when needed and eat a healthy, balanced diet full of vitamins, minerals, complex carbohydrates and protein to allow the body to heal.

My go-to medicine to get rid of a cold is... honey, lemon, ginger and paracetamol (as long as people don't overdose on this).

You should never pay for big name brands... Active ingredients are the same in cheaper products and it's just clever marketing.

To deal with the 8am appointment booking frustration... Pre-booking appointments can help avoid the rush. Every week there are set number of pre-bookable (routine) appointments, emergency (on the day) appointments, and appointments patients can book themselves using an online platform. As well as this, patients can submit an eConsultation via their surgery's website. Pharmacies can also deal with many common ailments from sore throat, to skin and urinary tract infections, insect bites, coughs, colds and allergies.

AI has its uses and more and more people are turning to it for medical advice but... I'd be very cautious of it as it's still in its infancy, and the issue with AI is lack of context and an inability to utilise the skillset that doctors have spent years honing. It also has no ability to empathise! As doctors we are so privileged that patients often tell us things they wouldn't dream of telling even their loved ones and with that comes a huge responsibility and a need to be heard and understood - AI simply cannot do that.

I'm very concerned about vaccine scepticism... A great example being measles. We had almost completely eradicated measles but due to the misinformation and gross negligence of certain researchers there was a lot of scaremongering that the MMR vaccine could cause autism. This simply is not true. Let me repeat that - this simply is not true. The published data that allegedly proved the link has been completely debunked and redacted and we are now faced with a real possibility of a measles outbreak. This condition can cause many serious long-term problems which can be completely avoided if children are vaccinated. If you have concerns, speak to your GP, health visitor or practice nurse.

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My top tip for improving a patient's mental health is... a whole-food diet. Exercise. Hydrate well. Have outlets in place to deal with the inevitable stresses of life. Foster good personal relationships/friendships. Optimise sleep and get some sunlight.

So many patients ask us to prescribe weight loss jabs and I'm not against them at all but... they must be used alongside diet and lifestyle changes in order for them to work effectively. These medications cannot be taken for life, nor are they designed to be. The problem is that if patients start these medications and lose weight, they often gain the weight back when they stop treatment. Every medication has side effects - these are no different. There are numerous risks ranging from pancreatitis to gallbladder and liver problems, visual symptoms, thyroid cancer and severe allergic reactions, so they must not be seen as an easy route. Having said that, they can be used safely provided the right patients use them with appropriate monitoring and follow up.

If I could tell patients to do one thing, it would be... to start being more positive and to have a better outlook on life. Numerous studies show that having a positive attitude is associated with better health outcomes - mind over matter.

The one thing I hate about my job is... the administrative burden, the bureaucracy and red tape. I also find it frustrating when hospital colleagues ask GPs to refer patients to other specialities rather than referring themselves - this negatively affects the patient journey and adds to my workload unnecessarily.

If I could go back and change one decision I've made, it would be... the decision to not take a year out to explore other opportunities after my first two years of residency. As medical students and resident doctors, we can often feel the urge to rush through training in order to become senior doctors but pivoting every now and then can help re-affirm the choices we make and helps us develop as people and clinicians.

We are so fortunate to have a healthcare system that is free at the point of access... but we have to remember when the NHS was set up life expectancy in the UK was nowhere near what it is today. People are living longer due to amazing advancements and that brings with it challenges that need to be overcome. For routine, elective cases, a lot of work needs to be done to reduce waiting lists and ensure patients receive safe, streamlined, effective and holistic service.

I strongly believe for life and death conditions, the NHS is absolutely fantastic... despite the multiple challenges it faces in its current setup. Cancer care is provided to an exceptionally high standard, and acute services are indispensable.

If I were the prime minister, these are the three changes I would make...

1. Moving to a model of neighbourhood delivery of care, whereby primary and secondary care teams work closely with community services and the voluntary/charity sector, to build a sustainable health service that is specifically tailored to the needs of the local population that it serves.

2. Adopt a more preventative approach to healthcare rather than a reactive model where we just treat diseases. Prevention will always be better than cure.

3. Improve social care services - if this is not done right, it can really hinder the patient journey and cause undue stress to all involved.

I wish people understood that General Practice is a speciality in its own right... Doctors don't just default to being GPs; there is a rigorous training programme with postgraduate exams to pass before being a fully qualified GP. We are not just there to refer patients to specialists, and there is so much we can do that people don't realise. Today's GP is a specialist generalist.

Have an interesting career and want to take part in this series? Get in touch with our Money live reporter Jess Sharp by emailing her at jessica.sharp@sky.uk

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