I both hate and love the list.
A patient waiting months for an hospital OPD appointment – not uncommon for them to come in with a list.
Nothing wrong with that. In fact, I actually encourage it. I want to make sure we address everything in that pressed time.
But I hate that the consultation becomes the list.
And, despite the list, too often the consultation ends with a Columbo-type moment, hand on the doorknob “Oh, doctor, just one more thing…”
Trust me here: Without fail, whatever follows the hand-on-door-questions is always really important.
If there was no other reason for me to gamble on starting a private practice with a new approach and focus, I would still have done it just to be able to finally ask this question and allow the space and time to really hear the answer. Patients sometimes still bring a list. But I encourage them to tell me about it. The story. Not a hurried checklist.
I love this recent piece in the Guardian. While the piece is about GPs, it could apply to any patient who attends the same specialty doctor regularly for a period of time – or years – for a chronic disease.
“Because of course the relationship between doctor and patient is not simply a nice-to-have. It saves lives. A growing body of research links … to a number of significant benefits: greater patient satisfaction, closer adherence to medical advice and medication, better uptake of vaccines, reduced use of out-of-hours services, lower referral rates, better job satisfaction and retention of doctors, fewer A&E admissions, even, according to a large-scale study … a reduction of up to 25% in mortality among patients for” whom there was long term continuity of care. As Professor Martin Marshall, chair of the Royal College of General Practitioners, told me: “If relationships were a drug, guideline developers would mandate their use.” [Extract from Guardian]
And I’m not alone. This years @dotMD conference was just Irish doctors reflecting on the stories: the ones our patient tells and how it changes ours.
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