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), an English physician working in Canada who promulgated the then radical idea of medical students spending more…
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 not omnipotent. Fortunately for me,…
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 the end of a…
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 to listen but difficult…
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 to swap stories of…
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.
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 view draws on a…
Work and life: balancing or integrating?
Work-life balance or work-life integration? Whose responsibility?
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 worked in primary care…