Are annual medical conferences worth attending?

GPFUQ #234  What’s the value of annual medical conferences?

Annual conferences hosted by academic and member organisations can be costly for attendees and risky for the organisers, but they can be very profitable, influential, and enjoyable events.

Every day, along with requests to write for obscure journals, my email inbox fills with unsolicited invitations to attend, speak at, or even be a keynote speaker at an international conference. Some relate to my areas of interest or expertise, but most have no real connection. These invitations are predatory,1 designed to flatter my ego and empty my wallet.

Even the value of reputable conferences can be a concern. Take, for example, the 2024 WONCA Europe 2-day conference in Dublin. A UK attendee would spend at least £1000 on conference fees, travel, and accommodation. Similarly, the 2024 Royal College of General Practitioners (RCGP) annual conference in Liverpool cost about the same but did offer discounts for specific attendee groups. Many participants may have their expenses covered by their academic or educational institutions. These conferences may not be predatory, but are they good value in terms of how they plan, assess, and report their economic, social, and environmental impacts and outcomes?

A generation ago, the large GP conferences were often organised by enthusiastic members of the hosting organisations. The aim was to strengthen the professional network and find and spread best practices faster. The quality of these conferences varied greatly from year to year and the financial risks were significant. Today, third-party commercial organisers frequently take on the financial risks, but impose their own rules and claim a share of the profits.

For instance, GUARANT International, a Czech company, organised the 2024 WONCA conference, and Haymarket Media Group managed the 2024 RCGP conference. Despite professional event management, UK medical conferences can fall short compared to the best in class (often their equivalent US conferences) in terms of their organisation, content, and experience.

These conferences can be important fund-raising events for their host organisations. Conference organisers need to have sponsorships, sell exhibition spaces, and attract presenters and attendees. They use marketing tactics to help them. These can include inviting potential attendees to be presenters at the conference, extending deadlines to attract more presenters, and adjusting presentation formats. For example, a presenter might submit a 90-minute workshop but be allocated only a 10-minute talk. If given a 90-minute workshop they may have a room that is too small or unsuitable for the session format. Commercial organisers may blame academic organisers for such issues, but complaints can go unanswered.

High-quality GP conferences should raise their standards and report on their ‘triple bottom line’ — the economic, social, and environmental impacts and outcomes.

From https://bjgp.org/content/75/754/222

What do GPs need to be know?

GPFUQ 235 What do you need to know to be a GP in 2026?

Every week news headlines call for GPs to have extra training in some area of health care. But what exactly should GPs know and be able to do in 2025 and beyond? The official answer is to refer to The RCGP Curriculum, written by the Royal College of General Practitioners (RCGP) and approved by the General Medical Council (GMC). This curriculum sets out the knowledge, skills, and attitudes GPs need. It also acts as the main framework for GP specialty training, explaining what doctors need to learn, why it matters, and how it should be taught. 

The curriculum is not a syllabus or detailed teaching manual for specific subjects. Instead, it provides a broad ‘roadmap’ of the areas GPs need to cover.The 2025 edition has grown to 419 pages, not including the super-condensed guides. You will not want, nor need, to read it all, but you may want to refer to it to check what you are now expected to know and do. These expectations are changing faster than ever before. 

When first published in 2004 after a long gestation considering what should define ordinary general practice it was deemed ‘essential reading for anyone with an interest in general practice.’1 It was designed to address the need for an explicit statement of the knowledge, competencies, and clinical and professional attitudes for GPs working in the NHS. In practice it now serves as the educational framework for the 3-year specialty training programme for doctors entering general practice and mostly reads as if the user is a GP educator or registrar.

What’s in the curriculum? It is split into two parts. 

The first part, Being a General Practitioner, starts with the latest definition of a GP: ‘A GP is a doctor who is a consultant in general practice. GPs have distinct expertise and experience in providing whole person medical care whilst managing the complexity, uncertainty and risk associated with the continuous care they provide. GPs work at the heart of their communities, striving to provide comprehensive and equitable care for everyone, taking into account their health care needs, stage of life and background. GPs work in, connect with and lead multidisciplinary teams that care for people and their families, respecting the context in which they live, aiming to ensure all of their physical and mental health needs are met.’

Throughout it reads as an instructional guide for GP training. There is only one paragraph aimed at post-qualification GPs and their lifelong learning: ‘Of course, becoming a qualified GP does not mean that your learning stops. Being a doctor is a process of lifelong learning, not only to keep up to date on medical developments but also to develop expertise and to improve the application of your knowledge and skills as you take on more senior and challenging roles. Your learning needs will differ at various stages of your career, and you need to be able to continuously review, identify and meet those needs. By linking explicitly with the GMC’s Good medical practice guidance, the RCGP curriculum can help you with this process, providing a useful educational framework for the discipline of general practice.’

The second part is a series of topic guides that explore specific capabilities in more depth, applying them in an appropriate professional or clinical context. Each topic guide is intended to illustrate important aspects of everydaygeneral practice, rather than provide a comprehensive overview of each clinicaltopic. Educational jargon peppers the text, sorting issues into domains, frameworks, scopes, and capabilities that can make it harder to follow. There is a new area of work, ‘decolonising the RCGP curriculum’, with its definition given as ‘a process of addressing the colonial legacies that persist within modern medical education, and better understanding how the historical inclusion and exclusion of some knowledge and its producers has shaped the profession we work in’. The RCGP has begun to critically reflect on the origins and formation of our knowledge, how this is taught in primary care, and how it might create unhelpful power hierarchies. It asks: can these be reframed and reconstructed in the curriculum? Alongside the full curriculum, the RCGP has developed super-condensed RCGP curriculum guides on each topic area for ease of reference. Any GP would be wise to check their role as GP in each of these 27 easy-to-use super- condensed guides to be confident theyare keeping up to date. The curriculum is only available online and as a PDF. The new 2025 curriculum and its super- condensed guides can be accessed here:

https://www.rcgp.org.uk/mrcgp-exams/gp-curriculum/curriculum-resources

 

From https://bjgp.org/content/bjgp/76/762/26.full.pdf

 

 

 

Bringing back or taking forward continuity of care in General Practice?

GPFUQ #233 Can GPs still provide meaningful continuity of care?

GPs can manage their own workload better and more fairly if they have continuity of care in a personal list system. As an appraiser I visited many GPs in shared list practices who felt stressed because they had little control of their workload. My practice switched from a shared list to a personal list system many years ago. Before the switch any of the practices 14,000 patients who happened to consult me could became my ongoing personal responsibility. After the switch to personal lists, I had about 1400 personal patients. All the rest had their own GP who was responsible for their ongoing problems. Of my 1400 patients only about 100 needed significant extra care at any one time. Their timely access to care improved because of the trusted relationships in a personal list and a reduction of avoidable appointments with other staff in the practice.
In these times of low morale and increasing demand we need better ways to manage workload for the benefit of doctors. Personal lists with continuity of care are a low-cost, high-quality way to provide better access for patients to their trusted GPs, and bring forward a new and sustainable generation of family doctors who can enjoy the privilege of these caring relationships.

From https://www.bmj.com/content/383/bmj-2022-074584/rapid-responses

Why do we ignore important warnings?

 GPFUQ #232 Why do we ignore important warnings like the threat to Planetary Health?

Its complicated, but see this short article https://bjgplife.com/planetary-health-a-warning-from-your-future/

 

How to have better interactions with patients and staff

 

GPFUQ #230 How do you have better conversations with others?

Ask yourself (or them): Do you want to be heard, do you want to be helped or do you want to be hugged

GPFUQ #231 How can you make the most of yourself or your team with only limited talents?

Always be the best at everything that requires no special talents

Do GPs need to be kind?

GPFUQ #229 Do GPs need to be kind?

From 2024 the GMC's Good Medical Practice guidance requires doctors to be kind to patients and colleagues. 

“At the end of the day people won't remember what you said or did, they will remember how you made them feel.”  Maya Angelou. 

Kindness in a caring profession is important but difficult to judge. It is what a patient feels. We each have memories of past great kindness and daily experience of common unkindness. We value kindness. For thousands of years different traditions have advanced the same practical message about the basics of how to be kind. The principle of treating others as you want to be treated yourself is known as the Golden rule. This makes common kindness easy to self-judge. If we follow the rule, most of us can be kind to our patients and colleagues most of the time. Competent doctors must be able to cope with difficult problems. This includes choosing unpopular actions after sharing the decision-making process with well-informed patients. I may want a competent doctor more than a kind doctor but I really want a competent and kind doctor. The new GMC guidance to doctors be kind (as in the Golden rule) seems Good Medical Practice for the 21st century.   

Can we bring back or take forward the ‘Family doctor’?

 GPFUQ #228 How do we bring back or take forward the ‘Family doctor’?

In this opinion piece for BJGP Life https://bjgplife.com/bringing-back-or-taking-forward-the-family-doctor/

Sir Kier Starmer has said ‘For those who want real continuity of care – we (i.e., the next Labour Government) will bring back the family doctor, that’s what people with long-term conditions need. But for those who just want a quick appointment at their convenience, who want a digital consultation, we’ll give those patients a different route.’*

Political rhetoric is not a solution. The problems in the NHS are complex. ‘Just do it’ solutions are as helpful as, ‘The beatings will continue until morale improves.’ The Government, the NHS management and all those with responsibility for fixing the structural problems like funding, workforce and social care must provide practical solutions. These are not discussed here. Instead, this opinion piece suggests actions GPs can take to improve the performance of their practices through the experience of having and being the family doctor. This is not a quick solution for every problem or practice but is a choice of the path to the solutions.

General practices are different. All have problems but some are more dysfunctional than others. Within each practice doctors are different. Variations in the standards of care are inevitable, and are desirable when they improve care. No one wants low quality care that fails the patients, the staff and increases the burden on the rest of the NHS.

Bringing back the 20th century family doctor with better relational continuity (an ongoing interpersonal relationship between a patient and one or more practitioners) is not enough in the 21st century. Now we need better informational continuity (the use of past, recorded information to make current care appropriate for each individual), and better managerial continuity (a consistent and coherent approach to the management of health or illness). None of modern continuity and the support needed for better care will happen without changes.

What can be done? These are five low-cost steps to take forward a modern version of the family doctor.

1. Agree what you are trying to achieve. The new family doctor is the means to better performance through a better process of feedback and change. It is not the end in itself. Start with a formal business planning process. The standard of the care that you provide for your patients, the needs of your community, your staffs’ welfare, your income and expenses always need scrutiny. These help decide what you should change. For example, a high-quality practice may want to become a triple bottom line practice or set explicit standards for providing the basic ABCDEF of quality care: good Access to care, providing the Best treatments, Customer satisfaction, providing appropriate Depth of care, Efficient and effective and Fair care for all. Switching to personal lists could help improve these and the overall performance of the practice.

2. Find out what is known already about what you are trying to achieve. Personal patients lists have not been valued by the NHS and mostly fallen out of use. Research may give some evidence-based guidance and other practices may have already tackled similar problems and share their practical advice. Relational continuity can be measured and is a proxy for the doctor–patient relationship and the associated benefits that happen when patients and GPs have repeated consultations together over time. The advantages include knowing your own patients, better health outcomes, improved mortality rates and the satisfaction both of patients and GPs. Limiting your responsibility and work for the other patients who consult you but are not on your personal list is a major benefit. Personal lists simplify reviewing the performance of each GP.

3. Commit to what you can do with your limited resources.

You can start slowly the process to personalise your patient lists. Most clinical systems have the ability to set the usual GP for each patient. This means you know who are your personal patients and your patients can know who is their personal GP, and gives both patients and GPs rights and responsibilities in that relationship. This does not mean you only see these patients or these patients only see you. There are many ways to accommodate the needs of both patients, GPs and the practice. A buddy system of cross cover with another GP can allow them to look after your patients when you are not at work and vice versa.

You can set explicit practice standards and decide how you will monitor your performances. A barrier is that many of the measures of an individual GP’s working practice are never examined, so improvement is difficult. A practice can set its standards of care and measure how its doctors compare. Examples of standards for an individual GP’s performance include personal list continuity (e.g., see their own patients 60% of the time), timeliness (e.g., seeing patients within 15 minutes of their appointment time), Team building (e.g., regular attendance at the informal team building meetings like ‘lunch’), fulfilling management responsibilities (e.g., each GP writes a short report each year on each of their portfolio of practice responsibilities), forward availability (e.g., patients should be able to book an appointment with their own doctor within a set number of working days).

You can manage individual GP performances better. Many practices have regular staff appraisals but do not include their GPs. Annual NHS appraisal and GMC revalidation do not usually help manage the performance of a GP in a practice. Each GP could have an in-house appraisal each year with 360 Multisource feedback. It becomes possible to understand an individual’s performance better when each has a defined list of patients, and an agreed set of performance standards.
You can find what is already known about this and spread best practice faster if you join an effective learning network.

4. Define what success will look like? Decide how you will know if your improvements have been a success, or a failure.

5. Establish when and how will you review these changes. You should monitor practice standards and act early when any performance falters. There are many reasons why GPs may not be working as well as expected. All merit investigation. Whatever the reasons, a practice should detect a problem early and take appropriate action to resolve the problem. Discussing and understanding the barriers to providing and improving care usually helps everyone. Identifying and managing quickly any problems in a practice that undermine goodwill and trust is essential, so they are dealt with before they harm your organisation.

None of the above need extra funding or exhausting labour. They do require commitment to change and taking forward the 21st century family doctor.

Reference*

Keir Starmer unveils Labour’s mission to create an NHS fit for the future, May 22nd 2023, https://labour.org.uk/press/keir-starmer-unveils-labours-mission-to-create-an-nhs-fit-for-the-future/ (accessed 21/6/22)