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Recovering the self: a manifesto for primary care

Recovering the self: a manifesto for primary care
Recovering the self: a manifesto for primary care
Huge political, ideological and organisational changes are engulfing primary care, placing intense pressures on the sense of self for both patient and doctor within the consultation.

A recent Health Foundation report urges us to develop care practices rooted in a philosophy of people as ‘purposeful, thinking, feeling, emotional, reflective, relational, responsive beings’.1 GPs are encouraged to work collaboratively with patients, fostering shared decision-making and promoting self-management. This assumes that patients (and doctors) have agency and capacity, the ability to make their own choices and decisions and the power to take action in a given situation. But these assumptions are problematic when you are running 15 minutes late during a morning surgery with 18 patients, most of whom are unknown to you, and your QOF screen pop-up urges you to update the patient’s CVD risk assessment score and take action to reduce their HbA1c levels.

We wish to give clinicians ‘permission’ to do person-centred care by offering a language of self that they can use to describe and defend their practice. Our principal motivations in establishing the centrality of the self in primary care are to offer hope to those entering the field, encourage those jaded by their current experience in practice, and provide vital underpinning to the generalist cause.
0960-1643
582-583
Dowrick, Christopher
1869ad5e-1959-446c-b2a8-3fcdf3e79667
Heath, Iona
2ef92fa2-c089-4324-a304-f416134b72b0
Hjorleifsson, Stefan
25625d43-a372-4e7a-9436-5325cbfd73f9
Misselbrook, David
f018f469-627e-4515-be16-99206f4c1a85
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Reeve, Joanna
36939e39-6aae-4f26-a74c-74768fd6e4da
Swinglehurst, Deborah
0026691d-fcac-477c-b8f4-2347f5268af7
Toon, Peter
264e03fe-a715-467c-afb5-fe05e639bae6
Dowrick, Christopher
1869ad5e-1959-446c-b2a8-3fcdf3e79667
Heath, Iona
2ef92fa2-c089-4324-a304-f416134b72b0
Hjorleifsson, Stefan
25625d43-a372-4e7a-9436-5325cbfd73f9
Misselbrook, David
f018f469-627e-4515-be16-99206f4c1a85
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Reeve, Joanna
36939e39-6aae-4f26-a74c-74768fd6e4da
Swinglehurst, Deborah
0026691d-fcac-477c-b8f4-2347f5268af7
Toon, Peter
264e03fe-a715-467c-afb5-fe05e639bae6

Dowrick, Christopher, Heath, Iona, Hjorleifsson, Stefan, Misselbrook, David, May, Carl, Reeve, Joanna, Swinglehurst, Deborah and Toon, Peter (2016) Recovering the self: a manifesto for primary care. British Journal of General Practice, 582-583. (doi:10.3399/bjgp16X687901).

Record type: Article

Abstract

Huge political, ideological and organisational changes are engulfing primary care, placing intense pressures on the sense of self for both patient and doctor within the consultation.

A recent Health Foundation report urges us to develop care practices rooted in a philosophy of people as ‘purposeful, thinking, feeling, emotional, reflective, relational, responsive beings’.1 GPs are encouraged to work collaboratively with patients, fostering shared decision-making and promoting self-management. This assumes that patients (and doctors) have agency and capacity, the ability to make their own choices and decisions and the power to take action in a given situation. But these assumptions are problematic when you are running 15 minutes late during a morning surgery with 18 patients, most of whom are unknown to you, and your QOF screen pop-up urges you to update the patient’s CVD risk assessment score and take action to reduce their HbA1c levels.

We wish to give clinicians ‘permission’ to do person-centred care by offering a language of self that they can use to describe and defend their practice. Our principal motivations in establishing the centrality of the self in primary care are to offer hope to those entering the field, encourage those jaded by their current experience in practice, and provide vital underpinning to the generalist cause.

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Accepted/In Press date: 11 June 2016
e-pub ahead of print date: 27 October 2016
Published date: 1 November 2016
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 396880
URI: http://eprints.soton.ac.uk/id/eprint/396880
ISSN: 0960-1643
PURE UUID: facbd2a3-33bb-4c33-8567-ac1f2124dbdc
ORCID for Carl May: ORCID iD orcid.org/0000-0002-0451-2690

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Date deposited: 15 Jun 2016 14:12
Last modified: 15 Mar 2024 01:01

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Contributors

Author: Christopher Dowrick
Author: Iona Heath
Author: Stefan Hjorleifsson
Author: David Misselbrook
Author: Carl May ORCID iD
Author: Joanna Reeve
Author: Deborah Swinglehurst
Author: Peter Toon

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