There is a tide in the affairs of men.
Which, taken at the flood, leads on to fortune;
Omitted, all the voyage of their life
Is bound in shallows and in miseries.
On such a full sea are we now afloat,
And we must take the current when it serves,
Or lose our ventures.

W Shakespeare. Julius Caesar Act 4, scene 3, 218–224

My situation is hardly that of the civil war here being fought by Brutus and Cassius, nor is it likely that omitting to seize this tide would mean that  the rest of my life will be “bound in shallows and in miseries.” Nevertheless, I feel that the time – or tide – is now set for me to seize the opportunity to make a change in my life.

Two days ago, I handed in my formal letter of resignation from the Practice.  In it I wrote:

As I think you are aware, I have very mixed emotions about my decision to retire nearly two years before I had previously intended.  I am deeply saddened by the realisation that I cannot continue working in the Practice, and I feel guilty about leaving at such a difficult time for my colleagues, the Practice, and the profession.  However, I am daring to start to feel excited about my plans to make this change in my life from GP to novice boatbuilder; from ‘scopes to saws, pens to planes and computers to chisels; from reports and scripts and tasks and referral pathways to paper plans, laying-up drawings, and a pencil behind my ear; and from the medicine I have enjoyed practicing for 32 years, to building and restoring wooden boats.

I have struggled emotionally with various issues, particularly the change of culture, moving from a small family-like Practice to the corporate structure and its ways of working; and with the breaking up and re-forming of teams which has been the necessary result of merging four Practices into one.  I will not miss the workload, and the pressure of work, which I have found at times overwhelming.  But, I will miss the medicine; the patients I know well, some for 28 years; and my colleagues, particularly those I have known and worked with for many years, who have become good friends.

I would like to take this opportunity to express my sincere gratitude to the Trust for having the vision of integrated care, and for taking the risk to take on my Practice, and others, securing the future of primary care in Gosport for the patients and all of us in post.  I am very grateful to the Practice Managers, who have taken on the huge challenge of merging four Practices, and forging a new Practice with SHFT (Southern Health NHS Foundation Trust).  They have worked so very hard on this project, and there have been some real successes. 

With just eight weeks to go before my last day in the Practice, letters, gifts and good wishes continue on a daily basis – all very humbling.  The theme is always the same: “I am so sorry that you are leaving, you will be really missed ….” only to be immediately followed by “… but I understand why you are going” or “… you’re doing the right thing for you.”   I find it hard to answer the recurring anxious question that frequently follows from my longstanding patients: “Who will I see when you are gone?”  I point to my remaining longstanding Partners, and praise their abilities and commitment.  However, I know that they are already struggling with the workload and its pressures, and the numbers of complex patients that they see.  The Practice continues to advertise for new doctors, but there have until recently been no responses.  Our Research sessions are to be filled by a locum for the next few months.  The backfill for the three doctors leaving this month is also with locums.  The good news is that someone is interested in replacing the Lead GP post that I vacated two months ago, but an outsider will find it difficult to take on a leadership role with long-established Partners.  It is sad but telling that none of the current Limited Partners are prepared to take it on.

With the majority of GPs planning to retire before they reach 60 (www.pulsetoday.co.uk/news/gp-topics/employment/majority-of-gps-intend-to-retire-before-the-age-of-60/20037119.article) the news today is that an RCGP survey reports that 30% of GPs are planning to retire in the next five years  

I feel sad and sorry to be adding to this ‘brain drain’ but the time has come for me to move on, and I must catch the tide, to gain fortune – of a non-financial nature – or surely succumb again to the workload and pressure which made me ill eight months ago.