Abstract
Winner of the 2015 InnovAiT writing competition
Last week I was comfortable in my role as a GP registrar; I had the backup of a familiar team and the confidence that comes from the knowledge that the buck didn’t have to stop with me. Seven days later and everything has changed. After a stimulating and slightly convoluted journey, I have finally completed my training and started work as a qualified GP at a new practice in a different part of town. A myriad of new faces whose names, foibles and tea preferences I try to remember. Different referral pathways, forms to complete and a new IT system that mocks me every time I attempt the most basic task. It’s all unfamiliar and unnerving.
Of course; this is nothing new. Like all doctors, I quickly became accustomed to the job changing every few months. What initially seems like a huge upheaval soon becomes routine, familiar and even refreshing. A nomadic training programme is a small price to pay for the opportunity to gain experience from different teams and specialities in the formative stages of our career. So what makes today feel so different to the previous seven?
I don’t think the difference lies in the patients. Despite a dramatic change in the practice demographics, the patients are much the same. They present with a problem (or more usually several) shrouded in fears, unspoken agendas and social concerns, and then look to me to help them find a solution. My ability to help hasn’t dramatically altered on qualification, nor does my certificate of completion of training suddenly mean that I am on my own; left to fend for myself. I am still part of a supportive and caring team.
Then it struck me. As my patients were getting up to leave, they were asking, ‘Are you here permanently?’ and it dawned on me why today felt so different. For the first time in my career, I could answer, ‘Yes’. I have no plans to leave this practice, or these patients, and it was obvious that this mattered. I don’t flatter myself that I’m a particularly outstanding clinician and I don’t believe it is my ability as a doctor that makes my patients so pleased when they hear I’m sticking around. What seems to be important to them is that I am their doctor. I will see them through this problem and the next. I will provide continuity as long as they require it; fostering understanding and mutual respect. In return, they complement me by choosing to see me again and trusting me to guide them through the most challenging periods of their lives.
Continuity – that’s what’s changed. It seems like such a small thing when I couldn’t offer it, but now I realise how much of a difference it makes to my patients; and to me. It’s intangible and easy to overlook, yet it’s a vital part of our role as GPs and we must preserve it and value it as much as our patients do.