Are GP Federations the answer for General Practice?
This week’s sketch is inspired by the return of TNG to Netflix.
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Sometimes you need to communicate a crucial point. To instruct individuals or a team to do something important. To encourage a trainee or team member to change a negative behaviour. It may be vitally important to a patient’s health or the success of your organisation. Fortunately medical training has prepared us well.
We know what to do. Present them with the facts. Support the message with data, graphs, risk ratios, tables and diagrams. This will help. Describe the options and the outcomes. Allow questions. Agree a course of action. Check understanding. Arrange to review progress.
People will then do what is best for themselves, society, or in the case of staff, the practice. Lose weight, complete the QOF prompts. They’ll be responsive to a logical case well made and do the right thing. Won’t they?
All too often, I find that, they don’t.
You will all recognise this story.
Tom is a smoker and we want to convince him to stop. We tell Tom that smoking kills 96,000 people a year in the UK, will shorten your life by an average of 10 years and that 80% of lung cancers are caused by smoking. The list of impacts and risks goes on. The logical case for stopping smoking is overwhelming. But, Tom had a friend… Bill. He smoked for 50 years and was fine. Until he stopped smoking. Since he stopped he had never coughed so much. He developed “heart trouble”, deteriorated and died. Bill always said that it was when he stopped smoking that his health started to go down hill.
“No doctor, I don’t want to stop smoking. It’s not worth the risk.”
Patients like Tom often show us the power of anecdotes and stories, and that they can be more compelling than the clearest of figures and facts.
It seems that many medics are missing a trick when communicating, motivating and leading. The use of stories and narrative are a great tool, and many professionals with technical and scientific backgrounds can under appreciate their impact.
Ask Practice Managers and GP Partners to list the challenges currently facing their practices and GP recruitment will poll high on the list.
Practices are facing a perfect storm of factors making it difficult to find and keep salaried and partner colleagues. Senior GPs are making an early dash for the exit and juniors are looking to other specialities or to more work-life balance friendly overseas or locum roles.
The issues almost roll off the tongue. Pension caps, insurmountable workloads, business uncertainty and risk, premises issues, increasing patient demands, more regulation, higher indemnity costs, the recent GP bashing mood of the media, and active recruitment by sunnier parts of the world. It’s enough to make even the most dedicated partner consider their position.
In many areas, even finding locum GP cover means using expensive agencies to find someone to drive across counties to the practice. It is not unusual for vacant sessions to go unfilled adding to the pressure on remaining staff.
Fresh thinking and innovation can throw up novel ideas and solutions to complex problems and turbulent times.
In 1439 Johannes Gutenberg combined the wine press and the coin punch to create movable type and the printing press. He revolutionised the world.
In March this year the the RCGP Vale of Trent Faculty applied an innovative idea to the problem of GP recruitment and retention in the East Midlands. Perhaps not quite in the same league as the printing press, but exciting none the less.
The worlds of speed dating and GP recruitment, together at last!
No, this is not Dr Puddle’s usual trip to the local Tesco Metro to pick up a ready meal after evening clinic. I’m playing a game. My old student penchant for computer role playing games, RPGs, has not entirely left me. I should probably be doing something more productive, like preparing for my appraisal next month. But then again, isn’t it important to unwind from time to time?
It would be nice to think that all those hours exploring dungeons and slaying orcs were not wasted. And, perhaps they weren’t.
Continuing Professional Development, CPD, is an essential part of life as a modern professional. Here in the UK, demonstrating ongoing development is a compulsory part of all doctor’s revalidation process. Over 50 hours of development activity must be demonstrated every year in order for us to be allowed to continue to practice medicine. As I reflect on how I plan to improve myself as a professional, it strikes me that RPGs have some powerful lessons to teach us about personal and professional development.
That RPGs incorporate elements relevant to CPD is not surprising. A big appeal of the RPG genre is the experience of improving your character’s skills and abilities as you engage with increasingly difficult but rewarding stories and quests within the game world.
All RPGs incorporate a system to model the accumulation of experience, skills and abilities. For example, the Fallout series quantifies a player’s abilities using the S.P.E.C.I.A.L. system. Player “stats” are rated 1 to 10 in the attributes of Strength, Perception, Endurance, Charisma, Intelligence, Agility and Luck. Your character starts the game weak and ordinary, but experience points earned through playing the game are spent improving your basic stats, and training in special abilities. Currency can be earned and exchanged for equipment and clothing, which further enhance “stats” and abilities.
So what can RPGs teach us about improving ourselves in the real world?
Continue reading “Levelling up! Six lessons about professional development from the world of role playing games…”
As a Doctor, dealing with patients, paperwork and the general cut and thrust of clinical work can feel like a real challenge. On top this, the added responsibilities of managing staff and running your team or practice can feel like an unwanted chore.
But it doesn’t have to be this way…
Leading teams towards change and improvements can be incredibly rewarding. It will amplify the positive impact you have on your colleagues, organizations and patients.
Leadership was conspicuous by its absence in my under and postgraduate medical training. I’m told that this situation is improving. However, there are generations of doctors out here who have reached leadership positions without ever giving the topic much thought.
Clinicians have spent years honing their communication, critical thinking, judgment and decision making skills. We have the potential to have a huge positive impact as leaders.