Challenge of culture, conscience, and contract to general practitioners' care of Challenge of culture, conscience, and contract to general practitioners' care of their own health: qualitative study
BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7315.728 (Published 29 September 2001) Cite this as: BMJ 2001;323:728All rapid responses
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Dear Sir
As the lengthy list of references demonstrates - we probably know
enough about this subject now to be doing something about it. It seems
rather ironical that just after the CMO has birthed the "Expert Patients
Initiative", with its firm nailing of the self-management flag to the mast
of healthcare as a model of best practice for punters, we have an article
demonstrating the Dark Ages of Medical Man.
Service users are being given a model that we as doctors can and also
need (not exclusively) to use. In the end not all service users are going
to be doctors but all doctors are going to be service users. Getting the
NHS right is not just about more money - it is about changing the sort-
everything-out-in-the-NHS mentality (whilst ensuring that this does not
also become an easy cop out to excuse under-resourcing by introducing a
nebulous type of DIY culture).
And if you want to sort your local services, just see yourself as a
potential user of them and ensure that, as a top priority, your PCO has a
strategy for looking after your mental health and your life-long learning
needs (protected time and space help here). Also, since everyone is
supposed to be registered with a GP (and GPs not with a GP partner), that
goes for all you secondary care doctors too!
Remember - "Your brain is not just for Christmas".
Synaptically Yours
Dr Chris Manning
Conflict of interest; an interest in conflict.
Competing interests: No competing interests
We do put our patients first. In large parts of the NHS there is no
effective cover for colleagues who are off. If we don't attend when
suffering mild to moderate illnesses some of them will simply not be seen,
clinics are not run and targets are not met.
Competing interests: No competing interests
Ofcourse GPs do not want to "dump" on their colleaques by going off
sick, but there is another attititude which pervades this issue.How often
have you heard a group of doctors each blighted with varying degrees of
colds or flus quip, " of course if we were patients/ receptionist/ nurses
we'd all be off for atleast a week" To paraphrase Basil Fawlty, do I
detect the faint hint of singeing martyr? Or the other John
Cleese/Pythonesque analogy, "My temperature was 110 and I still went to
work. That's nothing! I came to work still attached to the ITU ventilator
. That's nothing! I defibrillated myself with a set of old jump leads and
got the patient to "bag and mask" me while I auscultated his chest. That's
nothing!" etc etc.
These attitudes imply that those who succumb to ill health are quite
literally lesser mortals.We don't think we're superhuman, it's just that
every one else is weak.We ignore our own health to our peril, but we do
gain a shared, smug sense of martyrdom.We know we are human individually
, but can we admit this to each other or the rest of society ?Obviously
this is all mere anecdote and opinion. It is interesting to consider if
even qualitative research methods would have the ability to disclose these
or similar attitudes, perhaps a fly on the wall during coffee break ?
Competing interests: No competing interests
Are you really doing the best for your patients?
How effective or efficient are you being when you struggle to cope
with the demands of work while ill?
Isn't it time to put your own self care way top of your prioritites?
How many of the patients you see when ill could have waited?
And will someone say at your funeral 'He or she kept to the government
targets.'
When you look after yourself you will be a much more effective doctor and
will give out the message that it's OK to look after yourself. That can
only be a good example to your patients.
Competing interests: No competing interests