Wednesday, 29 June 2016

The GP as chess piece


One of the joys of working in general practice at my surgery is the daily coffee break with my other partners. I nearly always cone away having learnt something. Today one of my colleagues suggested that GPs need to be like knights on a chess board, willing to think laterally and change tack should the need arise. It got me thinking-the GP as chess piece.

 
The Pawn

Ok much GP work, like any other job is routine. Whether that be reading and writing letters, checking results, and dealing with some (although surprisingly few) straightforward problems. But pawns also only work at close quarters, they can never move far. As a GP it’s important that I can identify with patients. For me this has meant that getting older has given me opportunity to experience bereavement, personal illness, children growing up, and personal dealings with NHS, amongst many other things. I know how difficult life can be and am les critical of my patients who are struggling.

The Castle/Rook

The castle can move great distances across the board, but only in a straight line. I have increasingly made an effort to make contact with colleagues across the country who could advise me on various issues. With the internet and email it’s remarkably easy to track down the right person to ask. This in turn has been a great benefit to my patients. Not only can I access expert help, but generally it is immediate and it puts me in a good position to advise my patient’s accordingly.

The Bishop

The bishop can also cover large areas across the board, but in a diagonal direction only. Thus I have found it helpful through my career to not just gain knowledge form the obvious-what you might call, ‘straight in front of me’ sources (medical textbooks and lectures etc), but from novels, popular medical books written for the lay public, patients in other professions (GPs have a great opportunity to learn from our patients, especially when they have skills from academia, marketing, management, logistics etc-what a great resource GPs have meeting so many different people every day).

The Knight

As my colleague said, GPs need to be able to be flexible and think around problems. Patients don’t always know what their main problem is and we need to talk round and listen well to unpack what they are saying to try to find clarity for them. This may sometimes mean asking a question that initially seems rather angular, but may lead to particular focus. I think asking a great question is a skill all GPs need to work on.

The Queen

Ah the mighty queen. Able to move in all directions. All powerful. As GPs we need to be adaptable to our patients, whether that be their age, experience, education, ethnicity, life circumstance etc. A one size fits all just does not constitute good GP. Humour helps some patients and alienates others. An investigation is helpful for some but exacerbates anxiety in others. Knowing what to say and do when, and what not to do, must be developed through our careers.

 
The King

Dignified and slow moving. Hmm doesn’t sound like me. But I think an ability to be appropriately serious at times and thoughtful always,  is necessary. Even making quick decisions can still be conveyed in a considered way. The patient must feel they have been taken seriously. Sometimes just taking the pace off a consultation, and occasionally  just saying, ‘we really don’t have time now to properly help you, let’s meet again soon and make it a double appointment’, will give time for reflection and perhaps prevent unnecessary investigations and treatment which may have been arranged precipitately.


Now for Mah Jong.

 

A light touch

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