Memories of a great teacher

This week General Practice mourns the loss of Professor Sir Michael Drury, former RCGP president, professor and teacher at Birmingham University.

He was part of a 'double-act' with Dr Hull that provided most medical students at Birmingham a first glimpse of medicine, patients and future career options from a GP perspective. They were known affectionately as 'Dreary and Dull', although the teaching style was far much more progressive and challenging than ward based traditional methods.

From those early encounters I learned the important cornerstones to clinical practice of 'active listening' and the very special relationship between a patient and a trusted clinician. They have been important to me throughout the 30 years of my clinical practice.

But how do these principles fare in an era when we are moving towards more digital interaction, remote access, patient empowerment and control?

Well the evidence on uptake of digital Primary Care services is very biased towards clinical initiation and support being the key enabler. So where doctors, nurses and clerical teams take the lead, patients are far more likely to engage, use services and gain benefit. My own experience is that there is little expressed demand for 'control' where a relationship of mutual trust and involvement exists, but there is an increasing interest in using new technology to get information such as results and linked advice quickly and conveniently. Perhaps this is the 'control' I should be working on?

So we are working on registering as many patient as possible to have an opportunity to digitally interact, and we want to record patient communication preferences so that we can start to use the technology to keep patients informed, updated and able to safely self-care. As an increasing proportion choose a digital channel as the default first contact, we have new opportunities to educate, sign-post and support without further demands on Primary Care staff that are delivering beyond a safe and sustainable capacity.

There are risks and challenges, as outlined in MDDUS pointers this week in a GP medical publication, but without clinical leadership and development in partnership with patients, the temptation for political and strategy interests to dictate and micro (mis)manage will be irresistible.

Disruptive technology through electronic interaction between citizens and care providers is here to stay, and will increasingly change the way we expect to work and manage health. But I believe we need to maintain and enhance relationships between clinicians and patients, and not to give up ‘active listening’ in favour of computer algorithms!

PRDS

12/06/2014