Resilience: what is it, why do we need it, and can it help us?

General practice is the ‘Jewel in the Crown’ of our NHS, providing universal, free health care for a smaller proportion of gross domestic product than other developed nations. It is one of the UK’s greatest social and political achievements. In her extensive research, Barbara Starfield clearly demonstrated that the health of a population is directly dependent on the quality of its primary care system.1 GPs have always been flexible, innovative, and resilient. They are powerful and effective advocates for professional excellence, high-quality medicine, 24-hour care, compassion, ‘family medicine’, and equality and social justice. But GPs en masse are now unable to cope with the administrative, emotional, and human demands they face, and this crisis is compromising our vocation and taxing our humanity. What are the causes of our distress and how can we work with our patients and colleagues to resolve them? Financial stringency has resulted in systemic changes in UK primary care significantly increasing workload, eroding job satisfaction, and increasing stress (Box 1). One in three GPs have experienced exhaustion and burnout.2 A Worcestershire GP aiming at early retirement recently stated: ‘Every surgery in Worcestershire is at or beyond capacity. Most of us are dealing with over 60 patients per day … probably too many. I want to continue but the workload is too great, I’m both physically and emotionally whacked … many older GPs have already gone and there are not enough doctors.’ 3 Box 1. ### Systemic changes that have a negative impact in general practice #### Clinical