The Practitioner - 1868-2018: Supporting general practitioners for 150 years
 
 
 
 
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2015 Haslam

 

Why is it easier to give advice than to take it?

15 Dec 2016Paid-up subscribers

 ‘I suddenly realised that it was my pain, not yours. It was my job to sort it out, not the physio, or you doctor or anyone else. And so, for the first time, I actually started to do the exercises, and follow the advice you’ve all given me.’

Taken to task by my older patients

24 Nov 2016Paid-up subscribers

A crowd of around 20 people had gathered, and in their midst I could see a crumpled bike, and an even more crumpled elderly lady. I recognised her immediately as a lady in her late eighties who had been my patient for many years. I elbowed my way through the cluster of onlookers, and knelt by her side. She looked up at me from the ground, smiled, then turned to the crowd and announced: ‘Now you know. If you can’t get an appointment, this is how you get to see Dr Haslam.’

A memorable lesson in patient-focused consultation

24 Oct 2016Registered users

When I eventually turned back to the patient, I discovered that he was sitting there silently crying, tears running down his face. This, of course, was clue number two. It was not so much a clue, rather a slap in the face for my insensitivity. I apologised. I felt embarrassed and annoyed with myself. I immediately turned the computer off.

Better the devil you know?

23 Sep 2016Registered users

I tried to explain to my patients that the fact that they trusted me and were used to seeing me did not necessarily mean I was any good. But I also acknowledged that I knew how they felt, and how unsettling it can be when you have to see a new healthcare professional.

Treat all your patients like VIPs

01 Aug 2016Registered users

... That taught me a lesson. From that moment on, I tried to treat everybody equally. Either no-one should be treated as a VIP, or everyone should. I felt embarrassed at how rapidly I had been seduced into treating someone differently simply because of who they were. If you think a patient is a VIP, treat them just the same as everyone else. Treat all your patients like VIPs.

A little praise goes a long way

23 Jun 2016Registered users

Have you any idea how much your patients appreciate you? It’s so sad that so many doctors only find out how much they are appreciated, when they decide that enough is enough.

A lesson from a patient

23 May 2016Registered users

It was such a wonderful, unforgettable moment. The scene was a dermatology outpatient clinic, way back when I was a final year medical student. I can still picture it perfectly. A striking, red-haired young woman had come into the consulting room, smiled, and sat herself down....

Keeping yourself on track

25 Apr 2016Registered users

Making the same mistakes with ever increasing confidence probably applies to the way that many of us practise, or have practised, medicine. It’s a hard thing to admit, and probably a very hard thing to recognise. After all, if you do something that isn’t quite right – something as simple as taking a very minimal short cut – and you get away with it, then whether you are skiing or practising medicine the likely outcome is that you will keep doing it.

Choosing the right words

21 Mar 2016Registered users

In general practice, communication is everything. If the doctor and the patient don’t understand each other, the chance of any consultation being successful is dramatically reduced. It’s bad enough when dealing with straightforward but potentially embarrassing clinical conditions, when multiple euphemisms abound. However, when it comes to consultations about sexual health then the opportunities for crossed wires and misunderstanding are legion.

Communication skills are as important as diagnostic skills

22 Feb 2016Registered users

For your doctor to recognise and name the problem that ails you is the first step to treatment. In this world of ever increasing availability of medical information, clarity of diagnostic name is going to become more and more important, and the potential for misunderstanding becomes all the greater.

Mobile phones have transformed GP care

25 Jan 2016

When it comes to the world of general practice, I have a strong suspicion that during my professional lifetime the mobile phone is the single item that has had the most effect on GPs’ lives. It has fundamentally changed so much of emergency and out-of-hours care, and the way that it is delivered.

A tale of the unexpected

22 Dec 2015Registered users

She looked at me with total calmness and said: ‘I woke up during the night, looked at the clock – I remember it was half past four – and then I realised he was standing stock still at the end of the bed. He looked fine, that’s how I know he’s alright, but it was still a bit of a shock seeing him there.’

The simplest things can make the most difference

25 Nov 2015Registered users

General practice can be tough, but everyone gets thank you messages from time to time. Hold on to yours. When you have those inevitable days of self-doubt, take a quick look at your thank you cards.

Helping our patients to understand risk

21 Oct 2015

Every GP develops a profound understanding of risk, and of the sudden changes that can impact on anyone at any time. We see patients who are so unnerved by the risks that face them that life becomes impossible. We see patients who take so little notice of risk, that for instance, they smoke, and they smoke only to stop the moment that cancer is diagnosed. Helping our patients understand risk is a critical part of every doctor’s work.

Today’s facts will be tomorrow’s fallacies

24 Sep 2015Registered users

For many years I have collected old medical textbooks. The joy of these old textbooks is reading facts that we now know are totally wrong, but this is countered by the recognition that great chunks of what we know now will turn out to be wrong too.

We need to learn how to stop medication

05 Aug 2015Registered users

It was about 30 years ago, but I can still tell you every detail. I can picture his living room, the state of the front garden, every irrelevant pixel of the whole picture. I was doing a routine home visit to a 70-year-old patient of mine. Bill suffered from COPD but had also amassed a host of other conditions. Today we would have described this as multimorbidity. Back then we called them all chronic illnesses. Indeed, I don’t think we had such a thing as COPD – it was simply called chronic bronchitis. Anyway, as I looked at the extraordinary number of medications that my patient had accumulated over the preceding years, I vowed that it was time to try to rationalise them. Surely they weren’t all really necessary?...

Trust is the fulcrum of the doctor-patient relationship

22 Jun 2015Registered users

There is a great deal more to knowledge than mere facts, and there is more to caring than curing. For all human beings there remains a deep and continuing need in healthcare for a human relationship based on trust. Trust is hugely important in the doctor-patient relationship.

Plan for the unpredictable

21 May 2015Registered users

Time has to be the one thing that almost all doctors feel they lack. Within general practice the pressures on the typical ten-minute appointment seem to build all the time. If you know that unpredictable things are going to happen, then plan for them.

How my dog influenced the way I practise

23 Apr 2015Registered users

In a long professional lifetime, a huge number of people have affected me but one of the most profound influences was my very first dog. A Welsh terrier called Stan, an animal with the brains of a rocking horse.

All doctors should have their own GP

23 Mar 2015Registered users

I’m going to ask you a personal question. ‘Have you got a GP?’ It matters. You never know when you might need help. Doctors aren’t always very good at recognising their own healthcare needs. I know how busy you are, but doctors matter too. Please don’t neglect yourself.

Whose body is it, anyway?

23 Feb 2015Registered users

‘How do you feel about patients recording their own blood pressure at home?’ I would ask. My recollection is that around 95% of candidates were vigorously opposed to such an idea. They thought it unsafe, unprofessional, and unacceptable. I would ask them to explain the difference between their approach to self-measurement of hypertension and asthma.

Do you always reveal what you do for a living?

22 Jan 2015Registered users

I have certainly had times when I somehow managed to omit any mention that I was a doctor. It’s not that I’m in the tiniest bit ashamed of being a GP. It’s just that there are some situations where you really do not want to be asked your opinion on the best way to manage back pain.