National Trailblazer GP Session – 27th November 2020
Blog post by Dr Jayne Marston, Trailblazer GP 2020/21
This was a fantastic session led by Jonathon Tomlinson, a GP in Hackney.
It was useful to reflect on patients that GPs found challenging, I discussed this with my colleagues and we could all relate to how some consultations were more difficult than others and the themes mentioned in the presentation ran true, especially around long-term mental health problems and chronic pain.
The presentation made me reflect on why I found these cases challenging. As GPs we should be a ‘jack of all trades’ a true generalist, but it seemed some areas of medicine were consistently more challenging. As doctors we have a ‘fixer’ personality type, we strive to find solutions to problem, we all prefer ‘succinct’ consultations where the patient comes with x symptom, we give then y and they get better. In reality very few consultations are like this, patients present with a variety of symptoms and we offer them a range of treatment options with often varying degrees of success!
This talk about trauma informed care, almost turned the traditional model on its head. Jonathon talked about how the trauma impacted on an individuals current experience of symptoms (eg heightened anxiety, perception of pain) and very little about the traumatic event itself. It was the concept that what is left behind after an emotional trauma is important and not necessarily the event.
Given that we, as doctors, cannot treat an already experienced trauma or even the impact it’s left them with, Jonathon went on to talk about what we can do. He talked about the key concept of active listening, going back to the basics of good history taking, being kind, the validation of all symptoms (even those that are medically unexplained), vindication and building up a connection / relationship. This has helped me move away from the ‘must fix now’ model. It helps to see the consultation within the context of a longer term doctor/patient relationship and joint health goals; the integration of social security, relationships, physical and psychological well-being with the GP being central hub to other services rather than just a referrer.