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Helen Salisbury: Is transactional care enough?

BMJ 2020; 368 doi: (Published 28 January 2020) Cite this as: BMJ 2020;368:m226

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Re: Helen Salisbury: Is transactional care enough?

Dear editor,

As a retired doctor (with "multiple morbidity"), I am experiencing first hand what Helen Salisbury described as "transactional care". It was the last thing I expected I and my family would have to suffer after my retirement.

Helen Salisbury says she or her kind of general practice has been described as "old fashioned, nostalgic, and unrealistic". I cannot help but think that perhaps advocates of "transactional" as opposed to "relational" care are being carried away by convenience and self preservation.

I am sorry to say the good doctor's transactional practice sounds like a mechanic looking after my car. I think most human beings would dislike the idea that they are just a machine. Where has the empathy gone, yes the same empathy which attracted us to this profession in the first place and is the most important hallmark that distinguishes us from the rest of animal kingdom.

I think we have given in too easy to the pressures that the politicians have continuously put us under for the last few years. I say this because I think we should never have compromised our "relational" practice because it is the best and most rewarding aspect of our practice as well as the patient's well being.

Lastly, I think if there is a will, with improved and goal directed administration of our GP practices, we can still provide continuity of care for most of the patients for most of the time.

Dr. Noor M Yousufzai FRCPsych.
Retired Consultant Psychiatrist

Competing interests: No competing interests

13 February 2020
Noor M Yousufzai
Retired Consultant Psychiatrist