麻豆社

'There is gold in plenty and a wealth of coral, but informed speech is a rarity'

...a quote from Shakespeare? an aphorism of Oscar Wilde? It has been stuck in my mind ever since I had a conversation last week with someone I hadn't seen for over ten years. She is a GP in England, and she is at her wits end. In her words, General Practice has moved from being relational to transactional, from a process of listening to a request for a product.

She said that what had always nourished her was the face to face engagement with a patient, where the talk was about more than health, where you might intuitively pick up an unspoken concern, and where 鈥� by giving of your attention 鈥� you affirmed the patient's worth. But that source of nourishment is now in short supply. Because of increased demand and Covid restrictions in her surgery, appointments in person have to be briefer and focussed on delivery. And though Zoom calls and telephone or text messages have their place, they are no substitute for person to person contact. They enable an immediate response, but they do not necessarily facilitate informed speech.

Most people who engage in counselling know that the most important part of a conversation is not necessarily the first five minutes. Sometimes it is only when the patient is about to leave and the doctor asks, 'Is there anything else' that the bigger context is revealed of which the initial presenting problem is just a symptom. For the whole truth to be told, listening time is as important as medication.
NHS figures show that, in England, the rate of face-to-face GP consultations has changed little since the winter lockdown, with just 58% of patients seeing their GP face-to-face in August, despite the easing of restrictions. This has led some to accuse health professionals of 鈥渟hirking their responsibility鈥�. While malpractice cannot be condoned and these figures deserve scrutiny, there are surely many GPs who miss seeing patients face to face and who should be spared accusations of wrongdoing.

'There is gold in plenty and a wealth of coral, but informed speech is a rarity.'

That quotation is 2000 years older than Shakespeare or Wilde. It comes from The Book of Proverbs, a collection of wisdom sayings which illustrate a truth evident throughout the Bible 鈥� that the most commonly proscribed offence is not about the wrong we do with our bodies, but the hurt we can cause or the healing we can effect by our words.

Show less