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2013-2014
The healing power of the magic sponge
15 Dec 2014
I ran onto the pitch, took one look at the dreadfully swollen and excruciatingly tender ankle joint, and knew exactly what to do. I shouted at one of the spectators to call for an ambulance, and totally disrupted the game. Everyone was standing around looking more than a little worried, when the trainer came running over with a bucket and a sponge ....
Why do doctors and patients speak a different language?
24 Nov 2014
Why do doctors use the complex when the simple would do very nicely? If 80% of diagnoses are made from taking the history, and if communication is the absolute essence of history taking, isn’t it rather a problem that doctors and patients spend half the time talking entirely distinct languages?
A lesson in understanding patients’ health beliefs
23 Oct 2014
Many years ago, during my first weeks as a GP trainee, I learnt one of the critical lessons of my general practice life. I was well aware that everyone but my trainer knew that intramuscular penicillin was no longer the treatment of choice. Had I realised that I was totally failing to understand parental expectations, I could have handled these cases in a totally different way – though still avoiding the dreaded injections.
The changing face of general practice
23 Sep 2014
Just consider the extraordinary differences between general practice at the time of my birth and childhood and general practice as it exists now.
Technology can improve the doctor-patient relationship
25 Jul 2014
The potential for apps and add-ons to smart phones is almost beyond imagination. Patients will be able to download user-friendly health information that will radically change the relationship between doctor and patient to a much healthier partnership model, rather than the teacher/student, priest/supplicant hierarchical model that is still all too typical. However complex and digital and networked the world becomes, human beings will still need to feel safe and cared for. People who are ill will still be frightened, need someone to trust, and need a system that cares. We must never forget that.
Compassion should not be an optional extra
23 Jun 2014
If I ever did need to see him again, I would like to be under a general anaesthetic before the consultation started. Surely talking to patients with compassion shouldn’t be an optional extra. What do you think, doctor?
Education is not the filling of a pail but the lighting of a fire
22 May 2014
Education should inspire, not bore. Perhaps the most effective series of events I can recall involved different local surgeries and health centres hosting our monthly meetings. Each practice presented the three things that they were most proud of, and the three things that caused them problems. The things that may have caused one practice a problem had been solved by another practice and vice versa. By sharing our pluses and our minuses we were able to evolve and develop.
Work in partnership with your patients
22 Apr 2014
I was really struck by how many doctors thought it was a terrible idea for patients to be able to access their records, but were massively in favour of being able to access their own medical records.
Prevention is better than cure
20 Mar 2014
About ten years ago I remember a senior politician waxing lyrical to me about how fantastic the treatment of heart attacks had become, with rapid insertion of coronary artery stents and similar technical developments. I agreed with him that of course this was impressive, but then I asked him which he would prefer: a speedily fitted stent or not needing a stent in the first place.
Why we must be honest with our patients
24 Feb 2014
The more health information that there is available to our patients, in books, magazines, TV programmes, and the internet, the more important it is that we retain our trusted status as honest advocates who won’t necessarily just tell our patients what they want to hear, but will tell them the truth, and use the evidence honestly and openly.
What will be the next sea change in medicine?
22 Jan 2014
In the same way that you don’t really notice that a child is growing if you see that child every day, so the inevitable changes in the prevalence of different diseases tend to creep up on us unobserved.
Can you really die from a broken heart?
05 Dec 2013
Three weeks later, after a lifetime of perfect health, with the slimmest set of records, and not a symptom to report, he died at home. It was absolutely clear to me what the diagnosis was — a broken heart.
We need more generalists
23 Oct 2013
Most people with problems have multiple problems, and need a generalist to care for them, and of course generalism is the hardest specialty of all. Instead of the insulting question that we have probably all been asked: ‘Are you a specialist or just a GP?’ I can’t wait for the day when I hear the question: ‘Are you a generalist, or just a partialist?’
Why do our memories play tricks on us?
23 Sep 2013
I can never understand why I still remember useless pieces of information – such as the name of the bass guitarist in a long-forgotten group that was a one hit wonder in the early sixties – but struggle to remember some of the things that really matter. And before you tell me that it’s just my age, it’s happened all my life.
Is there a doctor on board?
25 Jul 2013
Halfway across the Atlantic, the inevitable happened. ‘If there is a doctor on board. . .’ I made my way towards the back of the plane, where I could see two men in suits leaning over another man who had collapsed on the floor.
Try to put yourself in your patient’s shoes
24 Jun 2013
As doctors we often wonder why patients fail to follow our advice. This was one occasion when it became all too clear where the problem really lay – our advice was impossible and thoughtless.
GPs can be key advocates for older patients
23 May 2013
Many older patients worry that they are receiving less care than their younger counterparts for the very good reason that the care they are receiving is less good. The Care Quality Commission found that while much care is good, fewer hospitals than on previous inspections were shown to be respecting people’s privacy and dignity, with nearly one in five failing to meet people’s needs. It is all the more important that those of us in general practice really do act as the powerful advocates for our patients that we can be.
Looking at cases through the retrospectoscope
25 Apr 2013
We can only do the best we can with the knowledge we’ve got at the time, so I don’t feel too embarrassed when looking at old notes makes you think you got something wrong. Looking back to today’s diagnoses from 35 years in the future, who knows which ones will have been discarded?
I’ll never forget that advice you gave me, doctor…
21 Mar 2013
It’s a phrase that I’m sure has been said to you. It’s certainly been said to me over and over again. The thing that has always puzzled me is when the wonderful advice attributed to you is something you simply cannot imagine ever having said in the first place. One thing general practice has taught me is that while we often get the blame for things that absolutely are not our fault, we also get the credit for things we didn’t do.
Do we just pay lip service to patient-centred care?
21 Feb 2013
‘I’m absolutely certain that patient centredness should be at the very core of our being. The worry is that it is sometimes a soundbite served up as a policy.’
Time to end the ten minute consultation?
24 Jan 2013
Many practices are bringing in changes, but others are just struggling, overwhelmed and exhausted.