18 Final thought: Eccentric locums Dr Euan Lawson explores what it’s like working on the fringes of GP society
can work hard and we can provide competent care, but many GPs still regard locums a little askance. Some GPs can’t comprehend a life without a desk to keep photos on, a favourite mug and simmering tension with a particular member of the reception staff. We’re deemed to be a little eccentric or just plain odd.
M
ost locums aren’t your “jobbing doctor” types. We
work to pay for a prolonged sojourn in Provence, or on the beaches of Goa. Other locums may run parallel careers, with the relatively high professional income subsidising a more bohemian lifestyle. I know one who spends his time doing house clearances before selling it all on at street markets. None of his fellow traders know he has a secret life as a GP.
Chatting recently to a
bearded elder statesman of heroin addiction, I could see the nostalgia bubbling up as he harked back to the halcyon days of his youth. When men were men and heroin was, well, at least made up of a bit more actual heroin than it is these days. He wondered aloud, with no trace of irony given he was in prison for dealing, at the morals of those that cut drugs. He bemoaned the current drug industry, by which he meant the illegal unregulated market rather than his disappointment in the performance
Some areas of general practice seem to have a voracious appetite for locums; they devour them, they can’t get enough
a quiet backwater. The local GP, himself something of an eccentric who wasn’t prone to superfluous politeness, told me it was the shallow end of the gene pool and that if you kicked one, they all limped. I didn’t try. The prison was running through GPs at an alarming rate and one of the most recent had got a quarter of the prisoners on sleepers. After a couple of weeks of stonewalling requests to keep a number of gents in the benzo style
Sometimes it’s difficult to avoid the conclusion that many sessional GPs are square-shaped doctor pegs in a system that only wants to provide nice little round practice holes. It seems that many career locums exist on the fringes of GP society. Locums might be more eccentric individuals, but they do tend to confine it to their personal lives. There is little scope for locums to indulge in radical prescribing policies, but it may be a clue when they turn up in a battered VW van that they harbour an alter ego. The surfer dude types are easy to spot: I’ve met more mature GPs who
The appetite for locums If locums are doctors on the fringes of GP society, it is fitting that their services are the most highly desired in the margins of wider society. Some areas of general practice seem to have a voracious appetite for locums; they devour them, they can’t get enough of them, and the usual suspects are the most deprived (or dysfunctional) practices, prison medicine, the MOD and out-of-hours care. In these jobs the patients are the ones more likely to raise eyebrows as they live their lives beyond the mainstream.
of his AstraZeneca shares. His life is unimaginable to the average person, yet his grumbles are just as humdrum.
The edge of the world It is a sad fact that the places with the highest demand for locums are the places with the greatest need and the fewest doctors. One prison I visited recently looked as if it was perched on the edge of the world and the nearby village was, to put it politely,
to which they had become accustomed, the prisoners made no attempt to disguise their mostly good-natured groans when they saw me walk into healthcare. I took it as a compliment. These days GPs are less eccentric in their professional practice, but GPs carry all the foibles and contradictions of other people. There’s little scope for mavericks in modern healthcare, but as a locum the whole vista of the GP landscape is opened up in a way that many GPs never experience. Eccentrics will often drift out to the periphery and life as a locum has a broad sweep. It’s what makes it so interesting.
Dr Lawson is a portfolio locum from Kendal and author of Northern Doctor’s Antidote –
http://northerndoctor.com
FINAL THOUGHT
SESSIONAL GP | VOLUME 3 | ISSUE 2 | 2011 | UNITED KINGDOM
www.mps.org.uk
ILLUSTRATION: JAYNE PERFECT
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