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69 Ideas Book Summary
Most People Over The Age Of 30 May Recall Their Family Doctor From Their Youth. They Were There When We Were Infants And Saw Us Grow Up. They Were Familiar With Our Tales As Well As Those Of Our Siblings, Parents, And Often Grandparents. The Relationship Of Trust Between Physicians And Their Patients Was Fundamentally Based On These Tales. We Are Now Seeing That This Extensive, Acquired Information Was Also Noticeably Advantageous In The Field Of Medicine.
Of Course, The Tales Were Only Told In Parts. Any Doctor Will Tell You That There Are Hints Of The Life That Goes Along With The Medical History, Such As A Former Tragedy, A Victory, A Family Problem, A Morbid Phobia, Or A Cause To Be Hopeful. It Would Be Similar To Seeing A Book As Nothing More Than Paper And Ink To Reduce Every Patient To Their Disease, Whether It Be A Tumorous Breast Or A Lethargic Pancreas.
While Important In All Medical Specialties, General Practitioners’ Main Line Of Work Is This Emphasis On The Complete Person. The Majority Of Them Like Their Jobs, Or At Least They Did In The Past, Since They Get To Maintain The Tales Of Their Patients. Because The Dynamics Of Primary Care Have Changed Along With The Rest Of The Globe. Nowadays, Few Of Us Who Visit The Doctor’s Office Anticipate Seeing The Same Gp Repeatedly. Covid And The Default To Remote Consultation Just Make The Fact That We Don’t Know Our Physicians As Well As We Used To And That They Don’t Know Us Worse. In Many Instances, Shared Narratives Have Made Way For Clinical Transactions.
Relationships Between Doctors And Patients Were Already Quite Problematic Before The Outbreak. Primary Care’s Humanity Was Eaten Away By A Mobile Population, A Doctor Scarcity, Excessive Workloads, The Shift To Part-time Employment (For Many Gps, The Only Way To Deal With The Demands Of The Job), Larger Practises, And Larger Teams. As Evidence-based Medicine Has Grown In Popularity, There Has Been A Movement Towards The Management Of Health Risk Via A Playbook Of Standardised Treatments. The Interaction Between Gps And Their Patients Has Suffered Unforeseen Repercussions, Despite The Fact That This Has Advanced The Treatment Of Many Disorders. Performance Measurements Are Biassed Towards Outcomes That Are Simpler To Quantify Precisely Because The Significance Of Those Connections Is Harder To Capture In Hard, Cold Numbers. The Illness Is Now The Focus Instead Of The Specific Patient, And This Is Also How Success Is Measured.
As The Number Of Patients Has Increased, Access To A Doctor Quickly Has Taken Precedence Over All Other Policy Objectives. Although Continuity Is Still Considered To Be The Gold Standard, The System Is No Longer Built To Accommodate It. It Isn’t Even Mentioned In The Scheme Of Monetary Incentives For Doctors Of Medicine. Care Based On Narrative, Relational Principles Is Becoming More And More Stigmatised As A Luxury, A Throwback To The Era Of Dr. Finlay’s Casebook, Or, To Use The Previous Health Secretary’s Phrase From June, “A Video Rental Store In The Age Of Netflix.”
I Am Not A Doctor, But I Have Spent The Past Two Years Studying Medicine, So I Do Know This. I Spent Several Months Seeing A Great Female General Practitioner At Work In The Same Rural Clinic Depicted In John Berger’s Famous Description Of A Rural Doctor In The Mid 1960s, A Fortunate Man. She Has Developed Long-lasting, High-quality Connections With Her Patients Over The Course Of Over 130,000 Patient Contacts Over More Than 20 Years, Something That Many Physicians No Longer Take Pride In.
In Our First Conversation, She, A Fascinating Storyteller In Her Own Right, Said: “Yes, It’s Necessary To Investigate Individuals, But You Figure Out What’s Going On From The Tales. And If You Give Folks Time To Speak To You And They Feel Comfortable With You, They May Share Priceless Medical Information With You.
69 Ideas Book Review
Because Of Course, A Good Doctor-patient Connection Is More Than Just A Nice-to-have. It Prevents Death. A Growing Body Of Research Shows That Sticking With The Same Doctor Over Time Has Many Positive Effects, Including Improved Patient Satisfaction, Better Adherence To Medical Advice And Medication, Better Vaccination Rates, Decreased Use Of After-hours Services, Lower Referral Rates, Improved Job Satisfaction And Retention Of Doctors, Fewer A&e Admissions, And Even, In Accordance With A Large-scale Norwegian Study Published Last Year, A Reduction Of Up To 25% In Mortality Among Patients Who See The Same Doctor. The Royal College Of General Practitioners’ Head, Professor Martin Marshall, Once Said To Me, “If Relationships Were A Drug, Guidelines Developers Would Mandate Their Use.”
A Hearing On Continuity Of Care Was Conducted By The Commons Health And Social Care Committee In May. Dr. Jacob Lee Explained What It’s Like To Visit A Patient At A Clinic Without Personal Lists. “You Are Attempting To Study Their Notes In Order To Obtain A Sense Of What Has Previously Occurred. When You Are Examining Blood Test Results And Letters For Patients You Do Not Know Since They Are Divided Amongst The Several Gps That Are In That Day, It Makes The Consultation Incredibly Difficult. To Attempt To Perform A Decent Job For That Person Is So Ineffective And Challenging.
We Will All Be Affected By This At Some Time. But If The Issue Isn’t Acknowledged More Widely, We May Not Even Realise What We Are Missing. According To A Longitudinal Study On Primary Care Continuity In England That Was Released In 2021, Less Individuals Were Not Only Able To Visit Their Choice General Practitioner, But Fewer Patients Even Had A Favourite Gp In The First Place. It Appears That We Have Forgotten To Hope For Or Even To Anticipate A Doctor Who Is Familiar With Our Cases. The Cultural Memory Of A Doctor-patient Relationship That Was More Than A Business Transaction Is Fading. And Why On Earth Would You Appreciate It Or Fight For It If You Have Never Experienced It?
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