I was chatting with someone a while back whose daughter is a GP. She told me that her daughter and the other GP partners were on the verge of closing their practice due to an utterly unsustainable workload. She was burned out and couldn’t take any more. As a last-ditch effort, they decided to try implementing the BMA’s safe guidelines on patient contact.
The British Medical Association recommends that GPs should have no more than 25 patient contacts per day to maintain safe and effective care. That number isn’t arbitrary – it’s grounded in what allows a doctor to give patients proper attention, make sound clinical decisions, and preserve their own sanity. Go beyond that and you get mistakes, rushed appointments, and sky-high stress levels.
Sadly, that limit is often blown past. In many surgeries, it’s common for GPs to be seeing 40 or 50 patients a day, especially where there are staffing gaps. The result? Burnout, early retirement, and a rota filled with short-term locums barely able to keep the wheels turning. This isn’t a system under pressure. It’s a system in freefall.
So they implemented the 25-a-day rule. And surprisingly, it worked. The relentless flood of patients slowed to a manageable stream. The doctors began to recover. And here’s the twist: patient satisfaction went up. It turns out people would rather wait a little longer to be seen by a doctor who’s actually functioning than get quick access to someone who’s half-dead with exhaustion.
Locally, GPs are now taking collective action. One of their main tactics? Refusing to exceed the BMA’s safe limit. But in truth, this shouldn’t be a temporary strike measure – it should be the standard.
Other industries already take this seriously. HGV drivers are legally bound to use tachographs to log their hours. They’re capped at nine hours a day (occasionally ten), with mandatory breaks. Pilots have even stricter regulations because one tired mistake at 30,000 feet doesn’t end well.
So why do we accept GPs making life-or-death decisions when they’re on their 47th patient of the day? Would you want your cancer symptoms assessed by someone who’s basically running on fumes?
The problem is, GPs are often their own worst enemies. Many are classic Type A overachievers – perfectionists, people-pleasers, obsessed with not letting anyone down. They take on extra shifts, answer emails late at night, skip holidays. Medicine attracts this personality type and then bakes it in deeper.
There was a story in the local press about a GP who hadn’t taken a holiday in five years. I know him. He’s a committed doctor. But honestly? That’s not dedication, that’s madness. Rest is not a luxury. It’s a basic human need. You can’t pour from an empty cup, and you definitely shouldn’t be writing prescriptions from one. Also it is a crazy situation that people who are paid so well (deservedly so) have such a poor quality of life.
This is why safe workload limits are essential. Not to punish doctors, but to protect them. Like speed limits, they exist to prevent crashes. If the system won’t enforce boundaries, the consequences are predictable: burnout, breakdown, or worse.
There’s also a cruel irony here. The people we rely on to keep us healthy often have terrible health themselves. GPs suffer disproportionately high rates of stress, anxiety, depression, and suicidal ideation. A 2019 study found that nearly 40% were emotionally exhausted. Some don’t survive it. GP suicides aren’t as rare as you’d hope.
The BMA now runs a confidential mental health service specifically for doctors. That it even has to exist should be a giant red flag. Doctors are human. They break too.
Part of the issue is that the health service has come to rely too heavily on goodwill. Boundaries are blurred. And while the flexibility can keep the ship afloat in the short term, it enables dysfunction. If GPs push back more firmly, perhaps the system will be forced to adapt into something more sustainable.
This doesn’t just apply to doctors, either. I’ve been through burnout myself, and it’s no badge of honour. The modern world is relentless. Work is infinite. And often we use work as a coping mechanism, which might suit the capitalist machine, but it doesn’t do our nervous systems any favours.
GPs are notoriously bolshy and allergic to being told what to do – which, to be fair, I can relate to. But maybe they need a health service bouncer who steps in at 6pm and says, “Right, time ladies and gentlemen. Put your stethoscopes away and go home.”
To any doctors – or workaholics of any stripe – reading this, let me leave you with some ancient Roman advice: memento mori. You are mortal. You are not as irreplaceable as you think. One day you will retire or die, and you will be astonished at how quickly the world carries on without you.
So take the damn lunch break. Set work hours and actually stick to them. Book the holiday and don’t cancel it. Close the laptop when the day is done. Yes, it’s easier said than done. But if you don’t build guardrails, the same patterns will run you off the road again and again.
Managing Editor of Slugger O’Toole. I help to manage Slugger by taking care of the site as well as running our live events. My background is in business, marketing and IT. My politics tend towards middle-of-the-road pragmatism; I am not a member of any political party. When not stuck in front of a screen, I am a parkrun Run Director.
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