Dear Patient,

You’re feeling vulnerable, I know. Disempowered, perhaps. Our health care system is not perfect and as a GP that is part of that system I am acutely aware of its failings. I thought that by writing to you, to let you know a little about me and what I hope to contribute to your health care you may feel more empowered. In any case, the GP-patient interaction is a relationship and knowing a little more about me and what I hope to offer you can’t hurt right?

The first thing I want you to understand is that nothing makes this GP more excited than when a patient has a preventive health win. Quit smoking or lose a few centimetres off your waist circumference and what you see is a professional looking woman smiling approvingly. What you don’t see is the internal mini GP me doing a happy dance. Seriously – witnessing my patients take pro-active steps towards improving their health is my favourite part of medicine. Those of you that are struggling to maintain a healthy weight or get off the cigarettes I’d love to contribute to your future win.

The path to becoming a fellow of the Royal Australian College of General Practitioners is a long one – cue the violins please. My experience was six years of medical school, two years equivalent of hospital residency and a further two years training as a specialist GP. GPs are specialist generalists (a strange term I know) and our training incorporates every field of medicine and  thousands of diseases. My responsibility to continue my education through quality improvement and continuing professional development is one I take seriously. There are times though when I won’t have the answers. Don’t expect me to pretend, or offer you glib replies to keep you happy. Instead expect me to pull out books and access guidelines during your appointment. This doesn’t mean I don’t know enough to help you, what it means is that I know where to look for the answers you need.

Sometimes the assistance you need to maximise your health will lie elsewhere and I will refer you to specialist and/or allied health colleagues. Working as part of a team for patients who have ongoing issues is an essential component of my role. If you do have other health professionals involved in your care please let them know I’d value, with your consent, being kept in the loop.

I run late more often than I would like. I understand this might make you cross, or impatient. My reason for running late is that one or more patients before you have had a health concern that just can’t be addressed in the allocated time. Often it is a medical emergency or crisis. What I want you to know is that I would run late for you too, if the need arose. One thing you can do to help me run on time is to ask for a long appointment if you have more than one problem to discuss, if the nature of your consultation involves emotional issues or if you are coming for a chronic disease check up.

 

Now just a few words for some special groups:

 

Women with young children.

You have the toughest job in the world – I know it because I live it too. I’d love for you to talk to me about some of the difficulties you might be having.   Breastfeeding struggles, kids not sleeping, worries about your child’s development. Much as I wish I had a magic wand to make those early years of parenting problem free (for myself as much as you) – I don’t.   We can however discuss your situation and together work out a plan, drawing on a host of resources to assist you manage your problems.

Those of you that are doing it tough.

You may have come in not expecting to discuss your current struggles. My room is a safe space. I hope you can be honest with me about where you are at emotionally. While we may not have time to explore all of your challenges today, we can make a start.  If it’s okay with you we can then make another appointment soon and give your emotional health the time it deserves.

My asylum seeker patients.

I welcome you. I welcome you to my country. I welcome you to my city, I welcome you into my consulting room.

Women that come in for a pap smear

Visiting the GP for a pap smear is probably the last thing you wish you were doing. If it’s been a while since your last pap smear, don’t apologise to me, I’m just glad you have come in today. I’m also going to let you in on a little secret. While I have a memory for patient’s stories I struggle with faces. I work hard to remember my patient’s faces, and the faces of those I meet outside my consulting room. On the plus side, I can promise you that next time we meet I will have completely forgotten what your vagina looks like.

The men who have come to see me because their partner made them.

Yay! I’m so glad you are here. Let’s make the most of this appointment to address not only the issue that your partner and possibly yourself are worried about. I know it may be a really, really long time before you see a GP again (although perhaps today I can convince you to come in for regular check ups). Consequently I’m going to take the opportunity to address some other preventive health issues too.

Anyone with a chronic disease

Asthma, diabetes and arthritis are just a few examples of chronic diseases that many Australians live with. Life is busy I understand that. One of the most important things you can do for your long-term health is to take some time out of your busy schedules to visit myself, or a GP colleague at least three to six monthly with your chronic disease/s being the focus of the consultation.   The reason – if we only see you when you have a short-term problem, such as tonsillitis, your chronic disease can get swept under the carpet. My priority is maximising my patient’s long term quality of life, chronic disease checks, where we can make a plan together for how to proceed is essential to doing that.

Everyone else – no special messages today I’m afraid. I am just happy that you are allowing me the privilege of sharing in your journey as your general practitioner. Thank you for the honour.

About the author

GP Danielle Esler

Danielle Esler is a general practitioner fellow of the Royal Australian College of General Practitioners. She has worked as a GP in the Northern Territory, Queensland, NSW and Victoria. She is also a medical educator training GP registrars and  runs her own business organising Quality Improvement and Continuing Professional Development workshops for GPs. Every other waking minute is spent with her three young children. She blogs about exploring her neighbourhood and the world with her kids at this blog, Bubs on the Move. This post represents an unusual intersection between her professional and personal worlds.

Disclaimer:

This post is supported by the Royal Australian College of General Practitioners.

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