Real-life story - Dr Patrick White
Patrick retired from general practice in the autumn of 2014 and now works 28 hours per week as a clinical senior lecturer, leading health improvement research projects, recruiting and supervising new GP academics, and providing education to academics-in-training.
The opportunity to seek solutions for clinical and epidemiological challenges, to collaborate with colleagues who share my passions, and to inspire and motivate young aspiring clinicians make this a job and a career from which I have no ambition to retire.
After my undergraduate training in Ireland I became a GP trainee in Scotland where I first developed an interest in research and published a paper about the care of epilepsy in general practice. It took around five years after registration to feel clinically confident and competent. After moving to London in the early eighties I undertook a Primary Care Research Fellowship at St George’s Hospital School of Medicine whilst working as a GP. Initially I spent eight hours per week carrying out a trial of GP education in asthma care, and seeking new research grants. Later, I doubled my academic hours, becoming a lecturer in general practice and primary care at King’s College Hospital School of Medicine until I took up my current position at King’s College, London. My qualifications include: MB, ChB, BAO, MRCP, FRCGP, MD.
There are three main elements to my work. Firstly I lead a research programme in chronic obstructive pulmonary disease (COPD), the modern umbrella-term for the smoking-related diseases of chronic bronchitis and emphysema. My interest in COPD research lies in understanding the causes, effects and patterns of the disease (that is, its epidemiology) and in how patients can be best helped to improve their quality of life and life expectancy. To do this it’s necessary to design new projects and seek research grants from funding bodies such as the NHS National Institute of Health Research and charities such as the Dunhill Medical Trust. Putting together research teams to undertake the research, and then writing up the findings for publication is often the climax of years of development of an idea.
The second element of my work involves the recruitment of new GP academics into the department as academic registrars and clinical fellows. I am responsible for their management as they progress through their training. Linked to this is the supervision of students undertaking their Master’s degree in Public Health. Thirdly I am involved with teaching including contributing to the Master’s degree in Palliative Care (within the Department of Palliative Care, Rehabilitation and Policy).
My current research is an attempt to find ways to improve access to treatment for COPD patients. We recently started an experiment in which we use lay health workers - volunteer patients who themselves have completed a pulmonary rehabilitation programme - to help patients overcome any barriers that may be preventing them from participating. We work closely with the Royal Society for Public Health, and we collaborate in this research with colleagues in a number of academic departments in King’s and in other universities. Another area of my research concerns the overprescribing of high-dose inhaled corticosteroids to treat COPD. In this experiment we withdraw inappropriately prescribed drugs and measure the effects on patients.
My role within the Department of Primary Care and Public Health Sciences is as an academic. My interest is primary care and public health. Clinicians in primary care get far less exposure to academic work in primary care and in public health than do those in other medical disciplines.
Attracting young doctors into the academic world of primary care and public health is therefore a challenge. It is essential to give them the opportunity to experience the challenges, pleasure and joy of research at the earliest possible moment if they are to see the potential for an academic career in primary care or public health. If they can get the opportunity to form a research question, complete a project and publish their work, they may catch the bug!
What is great about this role is the opportunity to use your imagination, to explore fascinating questions, and to construct a framework into which a research question can be placed. To then develop the research with colleagues and to work with other teams and organisations who share that vision provides the opportunity for a great deal of fun.