I can spend 10 minutes per consultation if people have straight-forward tonsillitis or gastroenteritis.
But what about the parents who are hesitant about vaccinating? I need more than ten minutes to make an impact.
What about the woman whose pregnancy test was unexpectedly positive, and needs to discuss options? She might not have anyone else to discuss options with.
What about the myriad people with psychiatric illness? I need more than ten minutes to figure out if it’s depression, or if there is a history of hypomanic spells. Is it substance induced? Is there another general medical condition? Who can start someone on antidepressants after a ten minute consult?
And what about the worried well? The old people with children abroad, with a bag full of chronic medication, and stories of challenges as numerous as the stars.
My dad has a favourite piece of advice for new graduates. It goes something like this:
Remember that when you come into contact with a patient, you may be the only person that touches them that day. The only person that hears their voice, that looks into their eyes. Make sure your touch is a kind one.
General Practitioners are pushed for time (and push their locums for time) because it’s the only way they can make any kind of profit, really. I understand that. But that is not the family medicine that I was taught, and I’m having trouble finding the balance.
Ever since I wrote about how going for therapy was my biggest gift to myself*, I’ve met with a few medical students to talk about the topic of mental health. Many of them were worried about their ability to make it through med school with their illness. Many were worried about the viability of a career in medicine with depression.
When I was a student, there was a rumour that students with mental illness would be excluded from the course. We were informed by our senior students, and they by theirs, and thus the rumour was propagated. Continue reading “Can I Be A Depressed Doctor?”→
Every few months, the mental health of doctors/medical students makes it to popular media. It seems like these spikes in attention occur, and everyone shouts YOU SHOULD CARE FOR YOUR DOCTORS! and then we write blogs and we tweet and we make youtube videos and eventually we go back to work, and nothing has changed.
If you’ve been paying attention, working hours of doctors (especially junior doctors) have been getting some good airtime over the past few months. The Province of the Western Cape has committed to actively reducing maximum continuous working hours for doctors to twenty-four, the HPCSA has promised to “look into it” (not that we have too much confidence there), and our biggest representative, SAMA (South African Medical Association) has come out in our support.
One of the things to come from all this is the launching of an armband campaign. This has its origins, I believe, from a similar campaign in the UK – although I have not been able to find any source to this link.