Patients often complain in general practice that they cannot see their own doctor. There is no problem with access but it is continuity of care that is lacking.
GP’s used to pride themselves knowing their patients and families well. In our practice we have 12,000 patients. We used to have six fulltime partners- that is 2,000 patients each. Now for the same number of patients there are 3 full time partners, 2 part time partners, 1 full time salaried doctor, 2 part time salaried doctors, a GP registrar, an F1 doctor and innumerable locums.
I saw a 12year old boy last week that had recurrent severe abdominal pains over 3 months. He had seen consulted ten doctors. He had seen two out of hours doctors, visited casualty twice, seen a specialist, and had consulted five doctors at our practice. He had lost lots of time at school and was on regular painkillers. The parents had no complaints about the doctors attention but they felt nothing had been achieved to relief his suffering or find the cause. I tended to agree, as the symptoms seemed genuine although difficult to explain. No professional had stood back at look at the whole story.
A call to the paediatric consultant was needed to get him admitted and sorted. I felt if he had one doctor who could have seen the pattern and knew the family well he could have been sorted out quicker. That is the job of a good family physician
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Similarly, an ongoing migraine through menopause resulted in strong pain killers and beta blockers (I rejected the latter). One insightful GP (my own was on hols) spotted that there were deeper problems. Mild depression - see a psychiatrist (scary!) recommendation for mind-numbing pills (rejected) - cbt (cognitive bevavioural therapy) recommended (accepted). Result? No more migraines (after 10 years). It turned out they were psychosomatic and once I'd recognised the 'triggers' that set them off, my own perception of the world took a new course and I began to feel so much better. This and the experience of many other debilitating symptoms kicked my enquiring mind into finding out more about what really happens to women as they age and why aren't we, the patients, told more about it. Why, for instance, are we not told that it is a natural occurence of hormonal defficiency to throw our metabolism out of sync and we naturally put on weight and the main point to this is that if women were better informed, weight gain need not happen.
ReplyDeleteA more holistic view and therefore preventive application of methods to improve nutritional knowledge to reduce illness must become routine in order for this epidemic of relying on pills to 'cure' everything to become a thing of the past.