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letter
. 2019 Feb;69(679):64. doi: 10.3399/bjgp19X700913

Are we propagating the inverse care law as GPs?

Aaron Poppleton 1
PMCID: PMC6355276  PMID: 30704999

Watt1 is right to acknowledge the disconnect between the political rhetoric of addressing health inequalities and the reality of limited healthcare provision in areas of greatest need. He has however failed to acknowledge the role that we as GPs have in propagating the inverse care law. Recognising our influence as GPs in workforce planning, policy, and medical education is important in addressing the gaps in provision. Bespoke resilience training,2 leadership, and pastoral support would improve job satisfaction in disadvantaged settings, rather than limited-efficacy ‘golden handshakes’.3 Offering academic GP training in disadvantaged communities presents another means of supporting GP recruitment and raising the profile of academic general practice. Directing research towards Cinderella specialties, that is, mental and public health, presents an opportunity for an upward cycle of community health understanding, engagement, and improved health outcomes.

As recognised in the editorial by Blythe,4 integration of a proactive GP curriculum in undergraduate medicine is essential, encouraging recruitment and incorporating social accountability in health care. This should go beyond taught theory, with hands-on participation in health promotion and research projects in disadvantaged communities.5 Achievement will necessitate more research-active practices outside university cities, and greater collaboration with third-sector organisations. Experiencing a ‘Tudor Hart’ positive impact will challenge students to consider working in such areas. In contrast, the status quo of increased practice workload in disadvantaged communities risks negatively impacting on GP trainers’ ability to engage and inspire medical students.

REFERENCES

  • 1.Watt G. The inverse care law revisited: a continuing blot on the record of the National Health Service. Br J Gen Pract. 2018 doi: 10.3399/bjgp18X699893. . [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Eley E, Jackson B, Burton C, Walton E. Professional resilience in GPs working in areas of socioeconomic deprivation: a qualitative study in primary care. Br J Gen Pract. 2018 doi: 10.3399/bjgp18X699401. . [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3.Marchand C, Peckham S. Addressing the crisis of GP recruitment and retention: a systematic review. Br J Gen Pract. 2017 doi: 10.3399/bjgp17X689929. . [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.Blythe A. Teaching general practice: a rallying flag for undergraduate education. Br J Gen Pract. 2018 doi: 10.3399/bjgp18X699881. . [DOI] [PMC free article] [PubMed] [Google Scholar]
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Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners

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