MOST estate cars are used for golf clubs, labradors or bringing back that awkward flatpack furniture box from Ikea. But Dr John Apps is - as in so many other ways - different.

His powerful Subaru Impreza 4x4 estate car is kitted out as a mobile medical unit, a kind of one-man MASH on wheels.

To ambulance crews and police officers attending accidents on the roads of County Durham, Dr Apps and his Subaru are a familiar sight. The Darlington GP is part of a network of specially-trained family doctors who are prepared to turn out at a moment's notice to help save lives.

His interest in BASICS, a UK-wide medical charity which has helped to save many road victims from death or serious injury over the last few decades, is just one of his unconventional interests, which have recently taken him on a personal voyage of discovery.

At 43, Dr Apps looked around him and decided that he had to get off the treadmill of general practice and do something else with his life. In common with many NHS GPs, he has seen the pressures of being a family doctor steadily increase. It is common to hear GPs say that few of their numbers want to stay in harness beyond 55, or even 50.

And, in a part of the world which is traditionally short of GPs, that is bad news for Health Secretary Alan Milburn and his plans to improve services in the region.

"Working as a GP was like running hard to stay still and finding you were still slipping backwards," says Dr Apps. "I felt like I was on a hamster wheel that was turned faster and faster and I had to get off, I had to reduce my workload."

Taking stock of his life, Dr Apps took one of the biggest decisions of his life - and quit as a full-time GP.

Walking away from general practice was not an easy decision after 16 years at the Neasham Road surgery. "I feel quite guilty because I have walked away from general practice The country trained me and I do still have a deep belief in the NHS and what it can still provide."

But Dr Apps says he thinks he has found a way to continue to put something back into the NHS and combine it with a more sane work-life balance.That new balance allows him to see more of his teenage family, his counsellor wife and to begin to think about indulging in the real love of his life - mountain walking.

From being a full-time GP, Dr Apps has re-invented himself. While he reckons his average working day is a lot shorter, he has now split his time between performing vasectomies on the NHS at a private medical centre, providing private acupuncture pain relief for patients with neck and back problems, and putting in the occasional shift as a casualty doctor at Darlington Memorial Hospital's Accident and Emergency unit.

Dr Apps believes his pick-and-mix approach to doctoring is something that increasing numbers of hard-pressed GPs may consider in the near future.

Apart from his NHS vasectomy and private acupuncture interests, there is also the small matter of helping to run what is thought to be one of the first services of its kind in the country - a private minor casualty service which also provides a range of first aid training for workers from the same Newton Aycliffe industrial estate.

So how did a GP get involved in something so unorthodox?

Through his interest in BASICS, Dr Apps has been closely associated for many years with what used to be known as CoDEV (County Durham Emergency Volunteers) which recently transformed itself into a private company called Medical Response Team (MRT). Based at an industrial estate off Durham Way North in Newton Aycliffe, MRT's predecessor has been associated with providing emergency cover at sporting and social events throughout the region. But now the organisation is branching out into areas undreamed off a few years ago.

Originally, Dr Apps' involvement started out as little more than a hobby, but he has gradually increased his involvement so that he is now the medical director of MRT.

"We have got superb facilities here and we are bang in the middle of a big industrial park," said Dr Apps, who runs his vasectomy service from the former CoDEV premises.

"Local companies might find it beneficial when someone cuts their hand and needs stitches to send them to us for immediate treatment, rather than sending them off to the local hospital where they might face a long wait," says Dr Apps.

Plans for the new centre, at Langton Business Centre in Durham Way North, are well advanced and the first patient should be seen within the next few weeks.

While it will only thrive if local companies see the advantage in having their own medical centre on their doorstep, Dr Apps is cautiously optimistic. "We could treat someone for a minor accident and take them home, or take them back to work and it should only take a few minutes. It also means that whoever is accompanying the casualty can get back to work without delay," he adds.

Indirectly, the medical centre, which is staffed by a team of fully-qualified paramedics and has a fleet of four ambulances, could help to take the pressure off local NHS services.

Dr Apps' colleague, Rosie Yates, director of training at the Medical Response Centre, says: "We are probably the first in the UK that has set up this kind of operation. One of the benefits of the service is that, not only does it get people back to work more quickly, but it also saves the health service time and money, especially for things like dressings." Dr Apps admits to feeling slightly uneasy at leaving full-time NHS work but, with the growing inter-dependence of the NHS with the private medical centre, he believes he can continue to contribute.

The Medical Response Team already provides out-of-hours passenger transport at hospitals in County Durham and Tyneside and there is scope for more close working relationships.

"I am very hopeful that we might be able to persuade the NHS to fund some of our acupuncture work," says Dr Apps, who became a virtual overnight convert to the Chinese pain-killer therapy when he found it cured his own neck problems.

"About 18 months ago, I really got into acupuncture in a big way. I had neck and shoulder problems and seemed to be getting nowhere." A visit to a medical acupuncturist, a practitioner who is also medically-qualified, was a revelation.

'After three treatment sessions I was cured. I started using it myself and have now treated about 100 patients. I have to say I have been absolutely astounded at the results," he says.

People who felt there was no hope to cure chronic problems resulting from back, neck and joint pain had all responded well. Dr Apps hopes that pilot schemes, which are already beginning around the country to fund acupuncture on the NHS, will allow him to treat patients referred by GPs for free.

Being selfish, for once, Dr Apps says the really important change in his life is the spare time he now has. He is planning to make the most of it among the mountains and hills he adores. "I miss the patients and I miss the banter of a busy surgery but there are compensations."

"Of all the frustration I had as a GP the one that really got to me was being unable to walk and climb in the mountains," says Dr Apps, who says he finally realised that, as well as looking after patients, he had to look after himself as well.