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The talking cure

Perhaps you will agree that the most famous Latin phrase used in Medicine for over two thousand years is ‘primum non nocere’ – translated literally as ‘first, do no harm.’ However, contrary to popular belief, Hippocrates was not the author of this axiom.[1] (Whilst that nugget of general knowledge might save you from making a mistake should you ever find yourself in the black leather chair opposite Jonathan Dimbleby on Mastermind, I’ll move swiftly on to a different Latin phrase that I believe is also of great importance in today’s NHS.)

Primum non tacere’ or, ‘first, do not be silent’ is a saying that I came across whilst writing my dissertation earlier this year on the ethics of whistleblowing. Arguably, this is not the only area of clinical practice that it is relevant to, as it may be possible to interpret it in several different ways. For the purposes of this blog though, I want to apply primum non tacere to the emotional health of both medical students and medical professionals. A conversation with a GP who graduated over seven years ago really struck a chord with me. She mentioned the fact that she knew several medical professionals who had fallen ill or quit their careers because of the pressures of the job. Let me tell you, for a medical student with three years to go before embarking on what I hope will be a long and satisfying career, such words are precisely not what you want to hear.

So, what is going wrong? Well, a quick glance around Pulse’s website and it is possible to identify several factors contributing to today’s doctors’ stresses and strains. Medical students feel stressed at times too - fear of failing exams, applying for a job, MTAS – you name it, they all impact students’ wellbeing. What is important though, is that as both individuals and as a profession, we remember that we have a voice. From the first year medical student struggling to keep up academically to the consultant who simply feels that he has too much on his plate, the opportunity should and must be there for anyone to be able to speak up when they feel that something is wrong. I’m not sure that enough medical students feel like they can be open when the going gets tough, and if they don’t know it now – when will they? I do wonder if students feel this way now, will it get worse as the stresses pile on when qualified?

The Francis report talked of a duty of candour with respect to patient care, and I think that this duty should apply to ourselves too. Suffering in silence does not necessarily solve the problem. In fact, it could make the problem much worse.

Chantal Cox-George will blog from the perspective of a medical student interested in general practice. Use the hashtag #nextgenerationGP to join in the conversation and follow her @NextgenGP


[1] Smith, CM. Origin and Uses of Primum Non Nocere – Above All, Do No Harm! J Clin Pharmacol. 2005. 45(4): pp. 371-372.