Choosing a General Practitioner

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Modern medicine is driven by an overly rational and mechanical worldview, now largely governed by protocols. Yet there is still a place for a good general practitioner – GP – for you and your family’s health needs.[1] This is even though medical practice has become dominated by scientific research and technology, on the one hand, (often by people who shun practice, or would ‘fail’ as practitioners), plus the intrusion of institutionalisation, governance, politics, and big business (such as the pharmaceutical industry), on the other.

 

Good practitioners know these limitations and ways of negotiating them for your health and welfare. Modern western medicine does have a place, but it is overly controlling and often deals with health issues that are not really part of its brief, or your GP’s training. Its best function may be restricted to accident and emergency, but equally important is the role of the GP over and above medical specialists. In this article, I am going to give some points as to how to choose a GP who will most satisfy your medical needs.

 

By the time I left medical practice, I had become disillusioned with modern western medicine and its direction. Although it took many years to arrive at this point, I had progressively lost faith. But this was mainly because my interests were in psychological and spiritual health, not simply physical disease, or the ‘physicalising’ and ‘disease-making’ of all suffering and pain. I also wanted to be a voice for change, and realised that I could not do that from within the profession; the restrictions are simply too great, I needed to be – in my son’s words – ‘unmuzzled’.

 

If you do not know me, please be aware I am not given to holding back on my views. I will inevitably be perceived by some as politically, ethnically, and gender incorrect. So be it. Some things simply need saying as they are seen. If you disagree, close the article and move on; it is not for you. And remember, these are my personal views, not necessarily those of the profession with whom I no longer have an association or, for that matter, an obligation.

 

I was not a career GP. After many years as one, I did psychiatry, trained as a Jungian psychoanalyst, and practised as a medical psychotherapist. I then consolidated this into a general practice setting, restricted my practice to being a holistic physician, and provided mental healthcare delivery. I have many years of general practice under my belt and have worked alongside GPs in various settings; private and corporate.

 

I feel qualified to give some pointers:

 

  1. Choose a career GP

 

Ask this of your GP; remember, you are doing the choosing, not vice versa. You are making a contract with a professional, so this should be part of your inquiry. Most GP’s have particular medical interests, so ask about this. Is general practice simply a stepping stone to specialisation?

 

Does the GP share your attitudes and values? Do they respect your beliefs? Here’s the first ethnic bit: Someone of a similar cultural background is more likely to do this innately. Now the sexist bit: If the GP is a woman and younger, what are her family intentions? This may be personal, but how would you feel entering into a relationship with her, and find her absent for significant periods of time?

 

Often your immediate community will have a good idea of this, so ask around. Indeed, your community may have input into all the points I raise here, so ask around. In my area, there is a Facebook page where such questions can be raised within the broader community, and I have seen such questions posed, regularly.

 

I have found that the best GPs are the ones who have what I call a ‘social conscience’. Check if your chosen GP has one, and this extends to wider social and environmental issues and beliefs.

 

  1. Are your beliefs respected?

 

I mentioned this above, but it needs highlighting. Beliefs, or whatever term you find equivalent, are the foundation of our existence in a spiritual and/or religious way. Health is fundamentally an extension of this, as in most cultures (maybe with the exception of modern western medicine) health management is integrated into a culture’s social and religious background, and setting.

 

This may entail challenging the GP on their own. This tends to be hidden and considered irrelevant by many; but I know I would not like to be treated by a fundamentalist of any faith, irrespective of ethnic similarity.

 

  1. Assert your power

 

Self-responsibility is built on empowerment. And empowerment is essential to any true healing, and not just problem solving. Does your GP grasp this difference? Do they not only tolerate your empowerment (by asking the questions posed here, for example), but also encourage it? How much do they support your choices and decision-making?

 

We tend to have a negative view of power in our culture; we tend to give it away too easily. And the consequence of this is that medicine becomes dictated to by protocols and the fear of legal intrusion, as well as governance by political and other institutions who have little or no understanding of the emotional demands of working on the medical frontline.

 

Don’t give your power away. Remember, you often visit a doctor when you are ill and hence relatively disempowered. You don’t tend to go when empowered, so maybe this is a good time to do the choosing, with some complaint that doesn’t rob you of your focus and authenticity.

 

Fear itself is very disempowering. Doctors can ‘trade’ in fear, particularly fear of death. They can tend to pathologise everything, in the mistaken belief that this is what you want; the security of a diagnosis.

 

  1. The medical setting

 

If the above doesn’t tell you enough about your potential GP, the setting of their office will.

 

It may be difficult to get beyond the corporate veneer, plastic chairs, and blaring television; but what about the GP’s office? Are you seated across a desk or adjacent? Is your GP’s chair sumptuous, whilst yours is plastic? Are there dissected diagrams of ears and hearts on the wall, or comforting pictures? Is there evidence of pharmaceutical intrusion? Where is the (inevitable) computer screen located; between you, or on one side?

 

  1. The medical encounter

 

Does your potential GP make eye contact? Does he or she listen to you, without premature interruption? Does he or she allow the computer to dictate, making notes as you go? If you have seen this GP before, do they remember you?

 

These questions lead to probably the most important point: Does the GP relate to you directly and engage you in a human encounter, and not use power dynamics of the medical relationship to dictate the nature and direction of the consultation?

 

Is the GP able to raise issues about sexuality, or respond to concerns of your own? Remember that, since Freud, there is a recognised and significant association between sex and health, beyond the simple pathology of STIs and the like. Irrespective of correctness and legality, this topic should be available to discussion.

 

Also, do not be afraid of a GP who volunteers their own stories and experience in the exchange. The narrative approach to medicine is now well recognised; it makes for a two-way street, and a levelling of the playing-field in the encounter. I believe it is an essential component of any true healing encounter. Also, it is important the GP uses language you understand and puts any problem in that context.

 

My belief is that the relationship with the GP is fundamental. Recognised or not, there are forces that flow in any therapeutic encounter that are fundamentally healing, irrespective of all the test results, diagnoses, and prescriptions.

 

  1. Tests, prescriptions and specialists

 

If the GP relies on tests for a diagnosis, maybe he or she is the wrong person for you.

 

In my view, tests should support or confirm a diagnosis or potential diagnosis that occurs in the encounter, not be the arbiter of one. And don’t be put off by a GP who says they don’t know or are unsure, it’s the ones who give such absolute assurance and certainty that may be of more concern.

 

Also, beware the prescription pad. Your problem may be physiological, or naturally self-rectifying, needing reassurance and advice regarding support, rather than a script. There are many levels of management that can come between diagnosis and script, often rendering the latter superfluous. If concerned, ask the GP if they’d take the prescribed treatment, or would they give it to a family member?

 

Also, a specialist referral does not necessarily mean you receive better treatment. Be selective, ask before accepting a referral. Is specialist treatment necessary? Or is it for a diagnosis? Most specialists put the two together, so if your GP is looking for a diagnosis only, this is all you should take away from the specialist. And, if you get a recommended treatment as well, maybe go back to the GP for his or her recommendation.

 

  1. There’s more…

 

There always is!

 

But maybe this is enough for starters.

 

 

©

Kennan Elkman Taylor

December 2017

[1] This article is directed toward people who are stepping or have already stepped beyond the restricted mental view of their life journey, to appreciate that the way of the soul both guides and directs their existence.

As health, illness, and disease is integral to this journey, how to engage a medical profession that in the modern era takes a restricted view in this respect, even to denial of the soul’s existence, is problematic.

As with all my commentaries on modern medicine, this article is written to assist those for whom the dictates of the soul are fundamental. For a fuller outline of my position and that of Soul Craft, please read my article What is Soul Craft?

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December 18, 2017

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