Dr Burnt Out: GPs are suffering with collective Stockholm syndrome

Dr Burnt Out explores the various types Stockholm syndrome experienced by all different kinds of GPs in relation to a broken system.

It’s not a new concept to suggest that those in general practice may collectively suffer from Stockholm syndrome – the psychological response wherein a captive begins to identify closely with their captors, as well as with their agenda and demands. 

I leave the choice as to who our captors might be at readers’ discretion – though they are spoilt for choice: NHS England, the DHSC, the health secretary, your ICB, or even some of your own colleagues. And indeed, some of the aims of our captors may be very laudable; it might just be their methods that we may disagree with.

Regardless, to me it certainly seems that currently all GPs are in some way imprisoned in the profession – at least until they plan to retire, whenever that may be. Though the whole of general practice is impacted by Stockholm Syndrome, each type of GP is affected differently.

GP partners are locked into a bad contract, poorly funded, often with ingrained estate, lease and building issues, and with unlimited joint and several liabilities if it all goes wrong. This personal liability harks back to the 1890 Partnership act, and I would suggest, for various reasons, it is unsuitable for general practice in the modern era. Unless partners retire, there is nowhere for them to go. There are no salaried or locum jobs, so they are stuck where they are – even if they are hating it – if they need to earn a living and remain working as a general practitioner.

Salaried GPs are similarly kept captive to the profession due to the lack of other roles available. So even if the terms and conditions of their jobs are terrible and they are also deeply unsatisfied, they dare not leave in case they find themselves joining the masses of hundreds of unemployed GPs. So again, salaried GPs are figuratively imprisoned within the profession and many feel unable to resign or move on to other GP opportunities (as there are not many).

GP locums are incarcerated in another way: they are almost completely excluded now from general practice, in many cases unable to earn a living, staring the other direction through the bars into the GP surgeries windows wondering if they can continue in the profession at all. Exclusion and banishment are the lot of the GP locum in the NHS in 2025.

So why don’t we just walk away if things are so bad? 

Well, I still believe general practice to be one of the greatest professions in the world – when it is done right. The reasons are tenfold: We get paid to help people; medicine and human beings are intrinsically interesting; many of us feel a loyalty and sense of vocation towards general practice; we enjoy working in teams with like-minded colleagues; we meet lots of interesting and wonderful people along the way; it is rarely boring and quietly simply the vast majority of us are not trained to do anything else. 

We are GPs, and we want to be able to make a living by being a GP. 

The current situation is not sustainable. Every type of GP has been cast into a vocational purgatory by forces beyond their control. On bad days, it seems like the best option is retirement – but how many of us can practically afford to do this if we are not at retirement age or even beyond? It is an unrealistic and individual solution. Something has to change on a profession-wide level; whether that’s a major shake up from captors, or the equivalent of a butterfly flapping its wings in China, I don’t know. 

But one thing is for sure: we have a warped psychological bond to this profession, and it is time we break free from our collective Stockholm syndrome.

Dr Burnt Out is a GP locum in London