GPs are dealing with huge changes and I am delighted the RCGP have asked me to run a session at their annual conference on resilience. As they face new demands the existing support structures are unlikely to work. I want to encourage people to realise they may have to think about themselves differently. We can then look at how this might change the conversations they need to have inside the practice, with the patients and externally. I think we will be struggling with all the Ds – Difference, Disagreement and Disinvestment . Finding useful conversations rather than destructive ones could be interesting.