Fighting for the soul of general practice : the algorithm will see you now

This collection of stories from two practising GPs describes the reality of working within a failing and highly bureaucratic system, where there is a balancing act: regulation versus relationships; autonomy versus standard practice; algorithm versus individual attention. We aren’t suggesting a return to a ‘better’ time.

We don’t object to being bureaucrats, embedded within and accountable to the systems we are in.

But we do want to consider how and with what the gap left by the old-fashioned GP has been filled.

We use stories based on our experience to describe the effect of different facets of bureaucracy on our ability to maintain a nuanced, individualised approach to each patient and encounter; and to question the prominence and effect of protocol.

We are interested in the way professional relationships are influenced by protocol: between and within organisations; and most importantly with patients/clients/service users.. We are accustomed nowadays to automated telephone lines, chatbots, website FAQs- the frustration of being unable to connect with another human being who will listen to our particular question and give us something other than a generic answer.

The same issues that are facing society at large have changed the way in which we work as GPs and the care we give.