Being a GP isn't about glamour. It's not about high tech equipment. It's not about cutting edge research, or shouting "Get me some paracetamol, stat!". There is very little drama. It's about the challenge of dealing with everything in a tiny amount of time. Of having the skills to develop an instant rapport with a patient you may have never met before...
When a photograph of an emergency room doctor grieving for a 19-year-old patient was posted online recently, it went viral with thousands of shares, likes and comments. Most of this stemmed from the fact that doctors are not known for showing personal emotions. Like all healthcare staff we deal with difficult, sometimes hugely distressing scenarios every day. We have all had moments like that doctor. Where a patient has affected us so profoundly, we cannot hold it together and need some space. This is a tribute to just five of the patients that have taught me to be a better doctor. Identifying details have been changed to preserve patient anonymity.
I believe wholeheartedly in consultation, engagement, empowerment, and ownership. But not as just buzz words to drop into meetings. Rather, I believe in what these words stand for at their best: genuine conversations between practitioners, partners, patients, policy makers and even politicians; shared insights into what works and what needs work; and a commitment to agreeing and delivering change, and all that that entails.
When I completed medical school, I left bemused. I was eager to start working but less enthralled by the fact that my tuition fees were spent funding a problem based learning (PBL) programme. I was young and foolish to believe that teaching myself medicine case by case with no expert guidance was how things should be done.
I was asked this week why the NHS doesn't fund all the new technologies available for patients, particularly those with cancer. And when I instantly replied "Because we can't afford to", I surprised myself. Because no-one seems to say that when they talk about the NHS. And the NHS doesn't like to say no.
Although free at the point of delivery, the NHS is not a 'free for all' and though treatment is not rationed, it must be rational. Having spent 15 years in the same job, at the sharp end of the NHS, I have seen fancy ideas and initiatives change policy and procedure, trying to trim the cost of the service...
Had I known that GPs were, of course, the root of all the problems in the NHS, with their daily failures to diagnose cancer, whilst simultaneously over-referring for all cancers, and ridiculous ideas that patients may share some responsibility for their own health, I would have instantly dismissed this career option. Instead I found myself working for the hundred, probably thousands of surgeries which are failing their patients. I was out on the streets, inviting half a million illegal immigrants to register and use the entire NHS free of charge.
His response to a bad reaction to drugs is to maintain or increase the dosage... You would think this one would be quite simple. If you had spent years without rashes, started taking a new item and then looked like a victim of contagion within a few hours, you may be wise to consider if this novel pill is causing a reaction.