The world of medicine that Dr Grainne Doran entered when she joined the staff at Bangor Health Centre as a recently qualified GP bears little resemblance to the one she leaves upon her retirement on June 30.
However, while she adapted to the changes in the world around her, Dr Doran has remained a consistent figure of trust, respect and knowledge to her patients at Church View Family Practice.
Though she intends to continue with part-time locum work there can be no doubting that her decision to retire will require some adjustment by the generations of families she has treated since joining Bangor Health Centre in 1992.
Certainly, Dr Doran is in no doubt about the gap that it will leave in her own life and she admits that it is the relationships with her patients that she will miss the most.
“I have patients I saw as babies and they are now having their babies and I have patients who are in their 90s now who I met when they were just retiring like I am,” she said.
“I have families where I have known the grandmother, mother, children and grandchildren, all generations through, and understand where they have come from and the troubles that they have been through and how it influences how they will be able to cope with things.
“I feel really privileged to have been a part of people’s lives in that way, that they are able to open up to you and tell you things they would tell nobody else.
“They trust you with the information and they trust you to help them make decisions about what they want to do about their health.
“I will miss that tremendously as that is a huge honour and I know of patients who I will miss meeting because they are a joy and I thoroughly enjoy that relationship that I have with them.”
Dr Doran credits the detective within her as the driving force behind her quiet knowledge from an early age that she wanted to be a doctor.
“There were no doctors in the family, it was a family full of teachers, but I just always wanted to be a doctor so that’s what I pursued,” she explains.
Born in Kilkeel, her family moved to West Belfast in 1966 and after qualifying from Queen’s University in 1986 she did her junior doctor training at the Royal Victoria Hospital.
“During my training I had looked at lots of specialities,” she says. “But I liked general practice because of the variety of diseases you are working with and because of the spread of age from cradle to grave.
“Also, the continuity of care because you get to know and follow people through their life rather than just touch base with them at hospital admissions.
“I found it most interesting and rewarding. I’ve always had a touch of the detective in me and I love the detective aspect of somebody coming in and you’ve no idea what’s wrong with them and you have to work out from scratch what the culprit is.”
Clear about the direction her career would take, Dr Doran completed her GP training in 1989 and in 1990 she worked for a year as a registrar at Skegoneill Avenue health centre in Belfast.
She then did some locum work before moving into community child health at Cooper Street in Belfast from 1991-92.
Though she had only previously been to Bangor as a holiday destination, she moved her life to the town when she was offered the position at Bangor Health Centre and has lived here ever since.
Her particular passion has always been for working in the areas of women’s health, diabetes and musculo-skeletal medicine doing joint injections and helping with postural and physical aspects of health.
The variety of treatments available for these and other conditions has changed the way medicine is practised, says Dr Doran.
“When I started out there were no such things as statins and the inhalers available for asthma were very limited,” she explains.
“How you treat disease has vastly changed and the role of GPs in monitoring that, and monitoring for side effects and for ill effects from treatments has hugely increased.”
These changes, added to an ageing population and a decrease in the number of GPs, has increased the workload on practitioners to the point where the way in which they work has changed almost beyond recognition.
Says Dr Doran: “Whenever I started out every mother who had a baby, we would have gone out to her house to visit her after she had the baby, for no reason other than to say ‘how are you?’.
“Every patient who died we would have called out to their husband or wife. Those sort of courtesy calls that were relationship building, there is no time for that any more.
“There is constantly patient contact to assess and treat. My phone calls start at 8.30am and I am constantly in touch with patients right through until 6 o’clock in the evening with 10 minutes for coffee in the morning and, if I’m lucky, lunch while I’m still talking to patients.”
Though some have blamed Covid for the changes, Dr Doran says that the pandemic simply made GPs more aware of the workload because they had to manage it differently.
She explains: “I don’t blame Covid at all for where we are right now. I think where we are now was starting before Covid and is due to the lack of GP numbers versus patients who need care. That proportion has changed enormously since I started.
“We have an elderly population that is getting bigger and they require a huge amount of care. Because of all the medicines we have now they all need monitored.
“The days when we only saw people who were actually sick on the day are long gone. There is so much chronic disease management and there are all the social aspects and the rise in mental health issues which are absolutely made worse by the long waiting lists to see consultants in secondary care.
“People can sit on a waiting list for two to three years and I have to support them all the way through those years until they get the treatment they need.
“That triples all the workloads because you are trying to support people who should already have been treated.
“All those things together make the workload significantly higher than it was when I started my training.”
There have also been notable changes in the way doctors communicate with each other and with their patients due to advances in technology.
“When we started out computers were only starting to come out,” says Dr Doran.
“We didn’t have computers in the surgery and we hand wrote every prescription. The mere idea of trying to do that now, I would do nothing else.
“Not everybody had a phone in the house and not everybody had a car. I remember we got our first mobile phone in the practice and we shared it between three of us. It was a brick.
“We use computers in medicine now both for record keeping and auditing and transfer of results and letters from hospital – the speed at which we can do that now compared to back then.”
Dr Doran’s dedication to her profession was recognised in 2021 when she was awarded an OBE, presented to her at Windsor Castle by Prince William.
“I was chair of the Royal College of General Practitioners for three years,” she explains, “and had done a lot of work with the Department of Health on the Transformation Agenda and the Multi-Disciplinary Team working within general practice.
“I think it was part of the work I did with that which led to my nomination for the OBE, which was lovely.
“Prince William was lovely, really informed and able to chat for ages about the work we do here. He does his homework.”
Although she knows she will miss her colleagues, her patients and the work itself, Dr Doran is clear that it is the right time to retire, for two reasons.
She explains: “We need to be able to find people to replace me and that’s getting increasingly difficult.
“We have some opportunities with some young experienced doctors coming through and I don’t want to miss that opportunity to take advantage of their availability at the moment.
“I also find that medicine is changing and the methods of communication on the electronic end are not what I was trained for. I was trained for more old-fashioned face to face relationship building medicine, but the workload doesn’t allow you to practise medicine that way anymore.”
She will certainly not be at a loss for something to do in her retirement, for in addition to continuing with locum work she has a number of other interests outside of medicine.
She directs the 12 member acapella choir, Cantiunculae and is looking forward to having the opportunity to spend more time in the garden and with her family.
Dr Doran also remains an active member of the Royal College of General Practitioners and says: “I mightn’t disappear completely from the medical field, I will probably continue to do some musculo-skeletal work because I really do enjoy doing that.”