The image of general practice is in the hands of GPs

People are dependent on the service given by GPs but there exists the perception that they are overpaid, says Dick Vinegar. Photograph: Alamy

My last two blogs have been advice for Dr Chaand Nagpaul, the new chair of the GPC. I am afraid I must importune him again, this time about improving the marketing of general practice. I find that GPs have an image problem. On one side, people are clearly dependent on the service given by their GPs, and surveys regularly show that 70% are happy with the service they get.

On the other hand, there is a strong contrary perception that GPs are greedy and overpaid in these hard times. And they have a very secure job, unlike the rest of us. Stories float around that two GPs earn more than £450,000, the highest earners in the public sector, and more than 1,000 of them take home £250,000 and above.

And doctors' pensions seem to be over £50,000, which is a high number when most pensions are being cut. Dr Sarah Wollaston, MP for Totnes, let the cat out of the bag on a recent Question Time, when she admitted that she had taken a £40,000 pay cut to become an MP. That means that she was earning £100,000 as a quite young GP.

I hear GPs complaining that these figures are gross, and their take-home pay is much lower, after paying for their receptionists, their surgeries, their insurance, their computers and their pension contributions. Some claim to earn no more than £80,000, and not to have met any other GPs earning more. I am confused, and I feel that Dr Nagpaul should tell us what the take-home pay really is across the profession. If the numbers are relatively low, it could help the image problem.

One result of the general feeling that GPs are overpaid is that the public does not take kindly to their complaints that they are overworked, at the end of their tether, and are so fed up that they intend to move to Australia. What's with all this whingeing, if they are paid so well? And if the government is grinding them down, then it is up to GP leaders to negotiate a better contract.

The image of general practice is in the GPs' own hands. And let us have no more talk of strikes - they are death to the image of GPs.

Doctors like to blame the press, particularly the "Daily Wail" for their bad image. I find this a bit unfair. Even in the "Wail", I find the short articles to be based on uncomfortable facts or surveys. They are usually negative, but nothing like as negative as the torrent of denunciatory patients' comments which accompany them. I get a sneaking feeling that it is these patients' complaints which get under the doctors' skins, not the articles themselves. But the doctors prefer to blame the media, not their own shortcomings, because the articles give a platform, which did not exist before, for unhappy patients to complain.

Perhaps, a General Practitioners Committee/Royal College of General Practitioners marketing exercise should investigate how to handle this new phenomenon; like making formal complaints procedures more user-friendly and responsive, or setting up a rebuttal service. These measures won't stop the trolls, but they might deter some of the habitual complainers. Every organisation has to learn how to handle the press. Recently, the medical profession has been spectacularly bad at it.

There is another way that GPs shoot their image in the foot. In their house magazines they make comments which make the hair stand on end. Here is an example from Pulse earlier this month: "I have no interest in knowing what my patients think of me. I try my best and be polite and nice to them but ultimately I'm here to manage their health, not enter in a popularity contest." Malicious hacks browse these publications for unprofessional comments like this.

Dr Nagpaul and Dr Clare Gerada have a lot of thinking to do about improving the image of general practice. It will be tough for them, as they probably consider marketing to be rather demeaning for "professionals" like them. But they must do it, if general practice is to realise its potential.

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