The Price of Care: A Reflection on What It Really Means to Be a GP

Every so often, a consultation stays with you long after the clinic has finished. This was one of those days — a reminder of what it truly means to be a GP, and why I still feel proud to be in this profession.

I saw a patient accompanied by some of their children. They had recently been diagnosed with bilateral pulmonary emboli and had been started on low molecular weight heparin. At first glance, this might not seem unusual. But when I reviewed the background in more detail, the reason quickly became clear.

CT imaging had revealed not only multiple pulmonary emboli, but also widespread lesions across the lungs, liver, spine, and pancreas — appearances highly suggestive of metastatic disease.

When Patients Know Something Is Wrong, but Not How Serious

The patient and family had been told there was a possibility of cancer. They knew the diagnosis was serious, but they hadn’t fully understood the scale or implications of what had been found on the scans. No one had sat down with them to go through it in plain language.

When I explained that the CT scans showed multiple metastatic-looking lesions, the weight of that information landed heavily. The reaction was one of shock — not because the diagnosis was new, but because the reality had suddenly become clear.

This is a moment many clinicians will recognise. Not a dramatic emergency. Not a new result. Just the point where understanding catches up with truth.

Treating Pain — and Creating Space

After giving them time, I assessed the patient’s back pain. Fortunately, there were no red flags for spinal cord compression or cauda equina syndrome, but the pain was significant enough to require stronger opioid analgesia.

More importantly, we sat and talked.

We discussed:

• what the scans likely meant
• what the oncology referral process involved
• what to expect over the coming days and weeks
• what symptoms would require urgent review

Because it was the weekend, oncology follow-up was planned within 48 hours. I advised them on red flags — systemic illness, neurological symptoms, or worsening back pain suggestive of spinal involvement.

All of this was carefully caveated. Scans can be re-reviewed. Specialists may interpret findings differently. Plans may evolve. But it would have been dishonest not to acknowledge what was in front of us.

The Value of Time in General Practice

Medically, most of the work had already been done. The hospital team had anticoagulated appropriately, arranged imaging, and referred to oncology. The patient’s observations were stable.

And yet, the consultation felt deeply meaningful.

For twenty minutes — in a busy GP surgery with a full waiting room — a family had the chance to sit down with a doctor, ask questions, and understand what was happening to them. The children were grateful, not because I had altered the diagnosis or fast-tracked care, but because they were finally given clarity, honesty, and time.

This is the part of general practice that rarely appears in metrics or targets:

• translating complex information
• supporting families through uncertainty
• providing continuity and context
• offering care when there is nothing left to “fix”

From Profound to Routine — All in One Day

The rest of the day returned to routine GP work. Prescribing antibiotics, analgesia, antidepressants. Reviewing chronic conditions. Adjusting long-term medications. Important, necessary work — but emotionally very different.

I hadn’t had a consultation like that in a while. And it reminded me why I enjoy being a doctor, even in a healthcare system under enormous strain.

What Is the Price of Care?

That consultation left me reflecting on a broader question: what is the price of care?

What are we willing to pay — financially, emotionally, and systemically — when we are unwell?

And how does that compare to how care is valued when it is being delivered day in, day out by GPs, nurses, healthcare assistants, managers, and administrative staff across the NHS and private healthcare?

Like many doctors, I am a terrible patient myself. When we are ill, we suddenly value time, reassurance, explanation, and compassion above almost everything else. Yet these are often the very things healthcare systems struggle to protect.

Bridging the Gap Between Care Given and Care Valued

There is a growing disconnect between:

• the care people hope to receive when they are vulnerable
• and the care clinicians are realistically supported to provide

If we want truly patient-centred care — whether in NHS general practice or private GP services — we need to bring those two perspectives closer together.

That means valuing time, continuity, and human connection as much as diagnostics and treatments. Because while scans, referrals, and medications matter, moments of understanding and support are often what patients and families remember most.

That consultation didn’t change a diagnosis. But it changed how a family experienced it. And that, to me, is the heart of good medical care.