Sheffield doctor and patient relationships now facing terrible strain
Some of the older wise leaders in general practice are calling for a return to what they call relationship-based care.
But this relationship is professional. It is not the same as a friendship. It has boundaries, it has to. Overstepping the boundaries, becoming too invested in each other’s stories, has it’s dangers. The best doctor-patient relationships maintain the warmth, compassion and mutual kind regard, without generating a dependence on each other.
I think the reason people are reconsidering this approach is we seem to have moved a long way from this at the moment. Telephone triage, online first, different doctor every time… different patient everytime. Our relationship is under strain, just look at the recent newspaper headlines.
Patients are getting angry and frustrated because they feel their practice is not maintaining the standard they expect. People generally reach for help when they’ve reached the limit of what they can cope with themselves, because they don’t know what’s going on, are worried it could be something serious, or think they may need a treatment that only the GP team can access. When you are frightened or concerned, you don’t want to wait you want to connect, usually in person.
The practice teams are overstretched, our numbers have dropped. Healthcare has got so ‘clever’ it has become very complicated, so much to keep up with and consider, so many demands. There just doesn’t seem to be enough time to do everything the guidelines suggest you ‘ought’ to do. We live in fear of missing something or being scrutinised for not considering every possibility. Judgement and instinct bannished amongst an expectation that we will do everything possible for everyone all the time.
In this situation it is so easy to blame each other. “You are not doing your bit”. It doesn’t feel like we are ‘there’ for each other. “Doctors have got cold and uncaring”, “patients have stopped thinking for themselves”. I really don’t think either is the case. We are facing a terrible strain on our relationship, not because either party has stopped caring or thinking, we are just all in an impossible situation, we are all just desperately trying to cope.