I have been a healthcare professional for over 40 years and a healthcare educator for 35 years. In this blog I consider the history of how healthcare professionals are educated and what implications this has for them, healthcare delivery and for consumers and patients. I write about my own experiences working in family medicine and as a healthcare consumer.
This blog and the articles are written to be of interest to learners, health professionals and patients/consumers. I would love to have feedback on the contents – comments can be made at the end of blog posts or via Twitter.
About this blog from Jill Thistlethwaite
A few words on words.
Health professions include but are not limited to nursing, midwifery, medicine, physiotherapy, occupational therapy, pharmacy, psychology, radiography…
As a medical doctor, I learned to use the word patient. In English, patient derives from the Latin ‘patior’ meaning to suffer or to bear. Dictionary definitions imply that patients are (passive) recipients of medical treatment or are under health care because of illness. Other health professions refer to clients or service users as well as patients depending on the context. I also use health consumer as consumers make choices and are involved in decision making. Consumers may also be family members and carers.
About me
A GP and an educator
I’m Jill – born in Manchester, I trained as a doctor (physician) in the UK at University College London 1975-81. After one year as an intern (house officer), I entered general practice (family medicine) training, which lasted three years. I was a GP in Yorkshire at a large practice with about 18000 patients, and also became a trainer/supervisor for GP trainees. In 1996 I started in academia, working at the University of Leeds Medical School as a senior lecturer. In 2003 I moved to Australia, where I worked as a GP as well as a medical educator. Since then I have worked in a number of medical schools and more recently at the Health Education and Training Institute in New South Wales.
My passion is interprofessional education (IPE) – that is the education of different health professionals together rather than professions learning their roles separately. See the IPE block for more information and the importance of teamwork in health care.
My interests
- Interprofessional education (IPE)
- Interprofessional practice and teamwork
- Professionalism
- Communication skills
- Shared decision making
- Women’s health
- Health literacy
- Involving patients and consumers in health professional education
Blog
The ‘new’ apprentices
Apprenticeships in health care are trending. The NHS (National Health Service) in England is considering an apprenticeship model for training aspiring doctors and nurses to help alleviate workforce issues.[1] The BBC is calling this a radical plan though it has been the training approach for some health professionals in the past. Indeed, clinical education…
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Ritual
Whatever one may think about the purpose and utility of royalty in the 21st century, the coronation of Charles III was a magnificent but eye-wateringly expensive spectacle. It may be the last of its kind in the UK, and I do feel that Australia will become a republic before too long. This was…
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Whither professionalism?
Towards the end of the last century, health professional educators began to take a greater interest in the topic of professionalism, and related concepts such as professional development and professional behaviour. Courses such as ‘personal and professional development’ (PPD), for example, were introduced into medical curricula and the number of published articles…
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How do you solve a problem like feedback?
Feedback – health professional educators and learners discuss feedback regularly. The literature on the subject is large. Yet we still don’t seem to be able to get it right or get the outcomes we want from the feedback processes we use. I attended an online presentation this week on feedback, which also asked…
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The Patriarchs by Angela Saini
When I was applying to become a GP partner in the late 1980s, general practice was a popular career choice for doctors in the UK. Competition was fierce. Each week I typed five or more letters to practices advertising in the British Medical Journal for new partners. After a few months and some interviews, it…
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Shared decision making: it takes two
Of the many articles I read each year, only a few have an immediate and lasting impact on the way I practise. Two papers had a great effect on me as a GP and educator in 1999. The topic of both was shared decision making. I am from a generation of medical…
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RCTs in education: yes, no or maybe?
Health professional practice is both a science and an art. Students learn about the scientific method and how medical knowledge is advanced through experiment, research and evaluation. Randomised controlled trials (RCTs) are a gold standard approach to gathering evidence as to whether treatments work and for whom. Treatments here may mean drugs (or medicines),…
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Bad news and emotions: caring for others and self
Sometimes it seems that there is only bad news and on days like those it is harder to remember the heart-warming events of my health professional life. Distressing episodes are more likely to pop into my mind and are more poignant. My earliest memory of having to break bad news as a…
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Constructed Truths – true or fake?
As a GP, a generalist health professional, I know a little about a lot. At my age, I have perhaps forgotten more knowledge than I have retained, or at least it is not as easily retrievable. In addition, some of the knowledge I have had has been superseded by new knowledge, new facts,…
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Good news, bad news: who decides?
A woman sits down and says: ‘I’m pregnant’. Pause. Context is so important here. How I respond is likely to affect our person-professional relationship, perhaps for some time. Is this good news or bad news or perhaps she hasn’t decided yet? One definition of bad news in the health care setting is ‘any news that…
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Empathy: Underpinning practice but vulnerable to stress
Look at most lists of the attributes of a good health professional and you are sure to find empathy. Ask a student to define empathy and you are likely to hear varying answers. In addition, there is frequently confusion between empathy and sympathy. As a desired attribute, there is pressure to assess for…
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Imposter syndrome: complex & common?
Every so often there is a surge in articles in which well-known people talk about their experiences of imposter syndrome, also known as the imposter phenomenon. In the last few years we have heard from Taylor Swift,[1]Jacinda Ardern,[2] Tom Hanks,[3] and ‘the pain of parental imposter syndrome’.[4] The prevalence of the condition varies from 9…
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Testing times
Towards the end of the high school year in Australia, news programs cover the year 12 examinations that help decide a student’s career path, such as going to university. Students are filmed sitting at individual desks writing with pens on paper, just as I did at age 18 decades ago and just…
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Getting to know you…
How much should a health professional know about a patient or client? When I consult with a patient new to me and new to the practice, I know their name, address, gender and age but typically little else. When I see these bare demographic details on the computer prior to meeting the…
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Babel – big themes wrapped in an gripping story
This is a work of speculative fiction set mainly amongst the ivory towers of Oxford in 1830s England. Babel is one such tower, officially known as the Royal Institute of Translation, which is rich with silver rather than ivory. Herein is the industrial revolution, the opium wars in China and the…
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I can’t remember the first time I heard the term ‘clinical reasoning’, but it wasn’t mentioned when I was in medical school. We were brought up on the concept of the ‘differential diagnosis’, which was introduced by William Osler (1849-1919),[1] an English physician working in Canada who promulgated the then radical idea of…
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First do no harm – but to err is human
During my hospital-based training, a senior clinician advised me that it would be unlikely that I would go through my medical career without receiving any complaints about my work. He was right. As health professionals we tread the line between doing no harm and keeping patients safe, while being human and therefore…
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Mud, burnout and doing our best
Before I knackered my knees, I was an ardent fell runner in the north of England (fells are rugged moor-covered hills). I even entered fell races, which could be quite competitive. The fell running community was mostly friendly but included an obsessive minority after personal bests at all costs. One time I was nearing…
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Language, context & communication
I am learning Italian. A new language is difficult at my age but also a good exercise for the brain. The app I am using is a fun way to tackle the basics, with exercises that include listening to sentences and then translating them. This reminds me how easy it may be…
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Learning from stories: ghosts and devils
Humans love stories. We love both telling and listening to stories. People particularly seem to like stories about health and illness, and about real and fictional health professionals doing their jobs. Television, film and literature are awash with medical dramas and autobiographical narratives that influence the way health care is perceived. Health professionals like…
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Let’s talk about sex(ual) history
Looking back in disbelief at my early years as a GP, I wonder how it was ever possible to have a 10-minute consultation for a first contraceptive pill prescription.
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A little more uncertainty
Uncertainty and not being able to handle uncertainty appropriately have costs for patients and health professionals. Practising in isolation is now uncommon though there are still clinics with a solo health practitioner. Practising within a trusted team may help with uncertainty as discussing patients with colleagues and seeking different points of…
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Work and life: balancing or integrating?
Work-life balance or work-life integration? Whose responsibility?
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Opioids, pain and the power of marketing
Fascinating book about the Sackler family, Big Pharma and the opioid crisis
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A welcome vision for Australian primary health care – but more details required.
Globally health services are under pressure through a combination of national and international factors such as, of course, the Covid pandemic, ageing populations, increased prevalence of long-term conditions, lack of sufficient and appropriate healthcare workers for local contexts, rising costs which are not being adequately met, and many more. I have…
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How can I be certain?
Uncertainty: the state of not knowing. Being a health professional: realising you cannot know everything and adapting to the state of uncertainty as appropriate for the context. Uncertainty is a state in which I spent much of my time as a general practitioner. As a medical student my scientific training led to my…
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‘Interprofessional’ as a marker of quality
Humpty Dumpty, Lewis Carroll’s egg-shaped character, said to Alice when she was through the looking glass that when he uses a word ‘it means just what I choose it to mean – neither more nor less’. There are many words and phrases in health care whose meanings depend on context and have…
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I’m looking for a long-term relationship
Finding and sticking with one health professional you can trust is an important part of health care. With the move to a more team-based approach in many health services, is this still possible and what are the implications for long-term relationships? How is the tension between quick access to health care when needed…
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Is every health care team unique?
‘The patient at the centre of the team’ is a much-used phrase when discussing health care. It derives from the concept of patient-centred care for which there is no consensus or succinct definition. Does being at the centre of a team give the person team membership? In which case there is a unique team…
Keep readingTeam-based care: who’s on my team?
There are more than 250 different health professions according to one source,[1] though I would be hard-pressed to list that many. I do know that the healthcare workforce is diverse and the professions within it have many different roles and responsibilities. Each person during their lifetime will interact with several of these professions, the…
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What does it all mean? A handy guide to health professional qualifications.
Health professional qualifications may be difficult to understand even, in my experience, by health professional students. In this post I consider these questions and others: What do all my doctor’s qualifications mean? Why are some surgeons referred to as Mr/Miss and some as Dr? Why is my English doctor not an MD…
Keep reading#menopause: there’s a lot of it about
Hot flushes are trending. One British celebrity has registered to trademark the term ‘menopausing’ to complement her book.[1] Scotland’s first minister has referred to the stigma surrounding the climacteric, admitting anxiety about coping in her public role once symptoms intensify.[2] In the last month the Guardian has published 8 articles on the menopause ranging…
Keep readingThe Pull of the Stars by Emma Donoghue
Three days in the lives of a midwife, a GP-obstetrician and a young hospital volunteer in Dublin in the midst of a pandemic and towards the end of the First World War. Most of the narrative takes place in a store room repurposed for expectant mothers with the influenza. The title of the book is…
Thoughts on becoming a doctor: part 2
An important question for health care practice is ‘who becomes a doctor’ or more specifically ‘who chooses and who is chosen to enter medical school’. Medical schools can support only so many students due to the size of facilities and, particularly, access to clinical learning spaces such as hospitals, clinics and general practices. Some countries have…
So, why did you want to be a doctor?
Thoughts on becoming a doctor: part 1 I must have been asked why I wanted to be a doctor several times during the process of applying to medical school in the 1970s. My chemistry teacher advised that this question was sure to pop up in interviews and that a reply including ‘I want to help people’…
My training to be a GP: at medical school
In the 1970-80s we had about 4 weeks of general practice during the whole 5 years.
University College London – pic from UCL
Interprofessional education
Click on the heading to learn about IPE and why it is important for modern healthcare. Complex and chronic medical conditions are best managed in partnership with the patient/consumer with a team of different health professionals working collaboratively.
Integrated care
The link is to an open (free) access article on integrated care and interprofessional education from 2022 published in the journal The Clinical Teacher, which I was editor of from 2014 to 2020.
https://onlinelibrary.wiley.com/doi/epdf/10.1111/tct.13552
I consider what integrated care is and what is required to help it happen.
Health professional education and practice 