Wednesday, 4 April 2012

The second opinion.

It's a time honoured and perfectly reasonable request-the patient asks for a second opinion. There are many reasons why the request may be made.

  • A dysfunctional consultation
  • A lack of confidence in the opinion given
  • Limited treatment options
  • A doctor who is unable to make a diagnosis
  • A condition and treatment so serious that the patient wishes to be sure of their options
  • and so on....
However what is increasingly happening in out-patients and general practices up and down the country, is that the patient wishes to see the same doctor only to be told, that the doctor has left the department, moved onto another practice, is unavailable for whatever reason, or that although the doctor may well be in the clinic, it will be pot-luck whether the named doctor will see them.

There is so much to be said for continuity. A growing confidence in the doctor, an increasing understanding of the context of the patient, and an ability to follow up differing treatment options amongst others.

I've just recently read Mark Greene's latest book entitled, The Best idea in the world-How putting relationships first transforms everything. It a great read and very pertinent to the idea of continuity. Although written from a Christian perspective (it is based on Jesus' teaching that the greatest commandments are to Love God and love your neighbour), it has much to say about relationships in the world of politics, commerce, family, and medicine.

On politics, 
The primary role of politicians is to create conditions in which people can flourish as whole human beings...we have pursued a form of capitalism that is much more concerned with economic growth than it is with social impact.
In our high mobility, high turnover culture most of us have fewer friends than our counterparts 50 years ago, and we are much more likely to live more than half an hour's drive away from relatives. And much less likely to work in the same company for 10 years, never mind our whole lives. Continuity builds trust...
I would suggest that there is much to say for doctors remaining in their posts as long as possible. Traditionally GPs would stay in the same practice for their working lives, in my own practice this is likely still to be the case. Hopsital consultants used to do the same, now they move around. It's all s unsettling for patients.

I've writtten  a short summary of The Best Idea, take a look here..
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