This site is intended for health professionals only

At the heart of general practice since 1960

pul jul aug2020 cover 80x101px
Read the latest issue online

Independents' Day

The new old norm

Dr David Turner

I cured somebody with my hands the other day.

It is a rare thing to do in medicine, and a deeply satisfying blip on the usual radar of self-limiting illness.

I reduced an incarcerated umbilical hernia and the instant relief the patient experienced combined with their subsequent gratitude for what I had done, very little in reality except pop a lump back in, made my day.

I relate this patient interaction partly to highlight the fact that despite the negative press we in general practice are often on the end of, patients do still appreciate us. I also highlight it partly to question how the ‘new normal’ we are all being told we have to adapt to is going to work in the three dimensional world.

A technophobe I may be, but there is no bit of remote technology that can lay hands on a patient yet.

Anxious humans want a real person in front of them telling them all is ok

Covid has certainly proven that a reasonable percentage of our work can be done over the phone, but that still leaves the majority that cannot be dealt with remotely.

Lumps, bumps, and even (ironically) skin rashes mostly need a three dimensional assessment.

There is only so much reassurance about abdominal pain - ‘probably just IBS’ - you can do before you need to get the patient in and examine them and yes occasionally, you are going to feel that tumour that has been growing during your telephone consultations.

Reassuring the worried well is a huge part of our work, and I was asked recently why this cannot now all be done over the phone and the simple answer is - the phone or video calls are no substitute for face-to-face or, as we are at the moment, mask-to-mask. I have called in patients for face-to-face consultations who I have spent a long time trying to reassure over the phone and the difference the real life interaction makes is stark. Anxious humans want a real live person in front of them telling them all is ok, not a computer screen.

We may be stuck doing mostly phone consultations for a while longer yet, but my bet is, when this is all over the ‘new norm’ for general practice will largely be going back to the old norm.

Dr David Turner is a GP in North West London

Pulse voluntary donation scheme

Since the outbreak of this pandemic, Pulse has strived to support you, whether it be through our resources page, our ‘Clinical Crises’ series, holding policymakers to account with exclusives such as practices being supplied with faulty masks, or GPs being told to stop routine services in the hardest hit areas.

However, good journalism cannot be done on the cheap and, like the whole publishing industry, we have been affected by the economic slowdown. We also strongly believe the content we produce should remain free as we feel it is essential for you. Because of this, we have set up a voluntary donation scheme. There is no compulsion whatsoever to donate. But if you feel we are helping you, and you would like to support us, anything you can spare would be greatly appreciated. Read more here.

Donate here

Rate this article  (4.64 average user rating)

Click to rate

  • 1 star out of 5
  • 2 stars out of 5
  • 3 stars out of 5
  • 4 stars out of 5
  • 5 stars out of 5

0 out of 5 stars

Readers' comments (2)

  • Over 25 years in GP I have mastered many satisfying tricks to brighten my day. Hernias are great, but what about

    1) lancing a paronychia and letting the pus ooze out into a pot of savlon
    2) releasing a subungual haematoma with the cautery - smoke, blood, mild peril, instant relief: what's not to like?
    2) reducing a paraphimosis (the white knuckle ride - who will break eye contact first?)
    3) popping in a ring pessary (which always seems like a magic trick and should be accompanied by a drum roll)
    4) scooping out a comedo with a green needle to prove it's not a melanoma. Instant cure
    5) tipping the liquid nitrogen onto the floor to create a rolling circular cloud, or freezing an elastic band and smashing it with your tendon hammer
    6) sucking out a ganglion - pure sorcery, one moment it's there...
    7) the improbable and inexplicable Epley's manouvre
    8) holding a tuning fork on the top of the patient's head, just because I can
    9) tendon hammers - just great
    10) and the best one... pretending that you are levitating the couch, when you secretly have your foot on the concealed pedal

    Unsuitable or offensive? Report this comment

  • Very funny copernicus. I will copy and send it my friends

    Unsuitable or offensive? Report this comment

Have your say