<<Did a tutorial with
registrars finsihing their scheme recently and was horrifeid to discover
they
had never been taught to inject a tennis elbow, could not give basic facts
about GP activity like annual consultation rates, yet their videos for
summative assessment are model consultations. There is more to GP than
being
nice to pts!!>>
Yes well I won't start on video consultations or we shall be here all
night! And I won't make any comment at all on the naked abuse of power
which adoption of videos for summative assessment represents----don't
really want a libel suit.
But yes, the teaching and the teachers have a lot to answer for.
Let us take the wider view.
First, we had consultants "teaching" everyone about organic disease to the
total exclusion of such psycho-social basics as whether the patient was so
terrified about some aspect of the disease that he/she could not handle it
or comply with treatment or want to get better or whatever.
Second, the older trainers tried to redress the balance and (I believe)
succeeded.
Third came the VTS clones of the 70s who (unlike their predecessors) spent
mimimum time in hospital and didn't really learn all that much about
organic disease. You can't learn general medicine in a six month
internship, half of it spent doing insulin stress tests on anything that
moves. But they learned the touchy feely approach and everyone loved
them.
Fourth, the patients copped on to the existence of doctors who LISTENED and
CARED. So they flocked in to see these new doctors and here we are, up to
the eyes in the worried well and the merely unhappy.
So yes I agree that GPs need to know organic medicine pretty well. But they
also need to be attuned to psycho-social factors too or they will do great
harm to everyone by medicalising non-medical problems.
Here endeth the lesson
Declan
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