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.

About the Author:

Rupal Shah is a GP in Inner City London and works as an Associate Dean for NHS England. As well as her many academic publications, she is a co-author of 'Our Mothers Ourselves', a memoir of mothering.

Jens Foell is a practising GP and Academic, who is deliberately choosing to work in undifferentiated primary care rather than a specialist service. He has an interest in mental health, chronic pain and health policy and was also trained in rehabilitation and social medicine.

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Fighting for the Soul of General Practice: The Algorithm Will See You Now (Global Health Humanities)

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