As a medical educator, I not uncommonly have doctors, who, eager to share their wisdom and experience, approach me with tricks of the trade they think might be useful to those I teach.  I really appreciate such gestures and have picked up some wonderful insights over the years in this way. Doctors’ willingness to share knowledge and experience with others is in stark contrast to those in professions such as law and in the world of corporate business. I’m proud to belong to a profession that values collegiality over the relentless pursuit of the competitive edge.

The preparedness to teach and share medical wisdom has long been a valued part of the medical culture, stretching right back to Hippocrates. Included in his 3^rd Century BC oath is “to teach them this art … without fee and covenant.”  Mind you, I’ve been told that ol’ Hippocrates was not so keen on teaching the art of medicine to women, slaves or surgeons, but as with any ancient philosopher, it is useful to quote the pieces of wisdom that suit one’s purpose and ignore those that don’t.

The FOAM movement is a shining example of medical collegiality. For the uninitiated, FOAM stands for Free Open Access Meducation – medical education for anyone, anywhere, anytime. Medicine is a rapidly expanding and ever-changing field, and ongoing learning is a constant and career-long responsibility for physicians. Proponents of FOAM want to “make the world a better place” by making access to up-to-date medical information and educational resources readily available, easily accessible, and free to all.

FOAM is independent of any country, specialty, organization, platform or media. In addition to distributing information via traditional websites, podcasts and online videos, FOAM uses social media platforms such as Twitter and Facebook to enable physicians all over the world to collaborate, discuss and share their ideas and experiences. This effective professional use of social media has demonstrated conclusively that Twitter is not just for twits, and that there is more interesting information to be found on Facebook than what some “friend” whom you haven’t seen since primary school had for dinner last night.

Emergency and Critical Care physicians have led the way in this, but many Australian GPs have also embraced FOAM. You may like to check out http://foam4gp.com/ and make Hippocrates proud.

Of course, old school face-to-face, peer-to-peer learning is still alive, well and wonderful. Corridor and tearoom chats, small group tutorials and conferences are all fabulous opportunities to hunt and gather clinical gems.

I was facilitating a multi-specialty workshop recently at which an orthopaedic surgeon, Dr X, asked to share his revolutionary tips for communicating with patients.  With genuine pride, he recommended “his” techniques:

“It makes the patients feel more comfortable if you sit on the same side of the desk as they do.”

“It is better to start a consult with “How can I help you today?” rather than “What’s your problem?”

“Patients like it if you let them dress and undress in private by getting a curtain or screen for your room, or by leaving the room while they change.”

Ground-breaking insights!

Mind you, he had a few less conventional ones such as recommending examining patients from a one metre distance when possible, but again, as with Hippocrates’ views, if helps to focus on the agreeable components.  Despite Dr X being a surgeon, I think Hippocrates would have applauded his willingness to share his wisdom with others.

As did I.

First published in Good Practice magazine, November 2014

In a recent discussion about the frequent shedding of tears in my consulting room (most of them not mine) and my resultant high rate of tissue box turnover, my mother said, “Having never cried nor even thought of doing same when at the doctor’s, I find that rather strange.”

It got me a-thinking. Her personal experience of what “going to the doctor” entails has shaped her view about what us docs do.  And it’s not just my Mum (who actually has a pretty good idea about the life of a GP thanks to many years of my stories) – we all make judgements in life based on limited personal experiences. I’m reminded of the cartoon showing several blind men each touching a different part of an elephant and arguing over what the animal looks like.  I’m stating the obvious, I know, but bear with me.

When I first started medical school, I had absolutely no intention of being “just a GP”.  As children, my brother and I were taken to our family doctor for immunisations and referrals but not much else. My recollections are of consults that went something like this:

“My son has a strange rash on his forehead. I’d like a referral to a dermatologist please.”

“Sure, no problem. I’ll write you one now.”

It surprised the hell out of me to learn that GPs diagnosed and treated all kinds of illnesses, and that many actually did complex procedures.  Thanks to an inspirational talk by a GP in my first year of med school and a great GP term in fifth year, I was sold on what general practice had to offer.

The message didn’t get through to everyone though.  I’ve lost count of the number of times my specialist colleagues have underestimated GPs’ capabilities. A urologist once expressed surprise that I was comfortable administering Eligard (leuprolide acetate) injections to a patient with metastatic prostate cancer. He seemed astonished that I was not only capable of mixing two pre-packaged components and giving an IM injection, but willing to do so.

I’m delighted to see the increase in positive promotion of general practice to med students and pre-vocational doctors.  Organisations like GPRA and programs such as PGPPP are doing wonders to attract the best and brightest to “the speciality which doesn’t limit”, and hopefully those who choose to pursue other paths will at least have a realistic idea of what we’re all about.

Perhaps we can also do more to enlighten the wider community as to what versatile and clever ducks we GPs are. A hip new TV show might do the trick. We haven’t been doing too well in TV-land recently.  Where once “G.P.” and “A Country Practice” appeared on Australian screens, audiences now take their medicine from TV hospitals’ dispensaries.  The morgue is the most popular place to linger – forensic pathology has been hot for years and is showing no signs of dying (sorry!).  Other than the UK’s “Doc Martin” (and that cranky old bugger doesn’t do us any favours), there is nary a GP in sight in recent years.  I propose that we follow our Australian veterinary colleagues’ lead. They weren’t doing too badly with Dr. Harry but have gone to a whole new level of sexy with Dr. Chris on “Bondi Vet”.

On the other hand, it might be wise not to let everyone know exactly what we do. If it became universally known that crying at the doctor’s is “the done thing”, it could send my tissue bill through the roof!

First published in Good Practice magazine, June 2013