Can GP’s take on the role of a ‘medical generalist’ or ‘expert in whole-person medicine’ within the NHS so as to improve standards for patients? Or should there just be better communication between healthcare providers across primary and secondary care in the NHS?
A new report by the Royal College of General Practitioners (RCGP’s) stated that the role of the medical generalist deserves more recognition and needs to be enhanced beyond general practice and primary care in order to respond to an ageing population as well as major financial constraints.
Medical generalists are focused on patient care as they take a holistic approach to treatment as they look at the individual wellbeing of the patient as well as delivering wider benefits for the patient in the long run. According to the RCGP, it is this practice that has enabled the NHS to be cost –effective for the last few years. GP’s need to be given more support and training if they are to take on this role which includes more time spent with patients and better communication with specialists.
These changes could work in theory as patients would establish a relationship with their GP over time through holistic treatment and patients themselves would be involved in deciding their own treatment. Even more, comprehensive data about a patient’s entire health history could be used to treat them as an individual and not as the generic patient population, not to mention that patients would have only one place to go in order to understand their condition. Unnecessary referral would not be needed. This data about a patient could then be shared with specialists and other members of the healthcare profession so that the patient gets the right form of treatment for their needs.
In addition, these changes would mean that GP’s would engage in more effective prescribing which in 2011 could have saved the NHS £200 million a year as reported by the Kings Fund. There would not be variation across the country and patients could expect GP’s to provide them with an efficient service. GP’s needed to work in multi-professional teams and move away from being ‘gatekeepers’ to ‘navigators’ who can coordinate long-term, continuous care for patients.
However, while this report specifically aims to improve relations between GP’s and specialists, what about the role of pharmacists and other members of the pharmaceutical industry? In 2010, there was a need for GP’s to work better with pharmacists so that public health outcomes and long term conditions could be improved. The following year, it looked like GP’s and community pharmacists still did not have the healthy relationship people had hoped, even after role guides were published earlier in 2010 to solve these relationship problems and to improve patient care.
Even more, there is no effective partnership between GP’s and the pharmaceutical industry. If there was, pharmaceutical companies could gain a comprehensive set of holistic data that could then be used to develop specialist drugs rather than the next ‘blockbuster’. It also seems that the NHS has never known how to move forward in the future since 2010. There just seems to be a lot of recommendations for improving patient care but none of it is or can be implemented in the near future.
For instance, the RCGP wants more GP’s to have more time with their patients. How is this going to affect the overall running of the NHS? There will be an increase in waiting times for patients and less money would be made from seeing fewer patients on a daily basis. All of these recommendations are based on further discussion and don’t have concrete support as of yet which is possibly why the community pharmacist relationship building exercise has not been brought up recently.
Additionally, how much would this extra training for GP’s cost? Essentially, it would seem like this new medical generalist role is in fact more specialist than the generalist skills that every GP currently possesses. Would it not be easier to just improve relations between GP’s, nurses, pharmacists, specialists and the pharmaceutical industry so that providing holistic patient care can be a more collaborative effort? Different professionals within the healthcare industry have never been educated properly about what they can do for each other and this is really where the NHS should begin. As a patient, I would not mind speaking to a variety of healthcare professionals. It is always better to get a second or third opinion. But what I do not want is being moved around from one healthcare professional to another because it is not clear who is best equipped to help me.
To sum up, the medical generalist role does need to receive more recognition but so does the value of what other healthcare professionals bring to the industry. It seems like ineffective patient care is happening as there is no collaboration between professionals in the NHS. They are not aware of the resources that each different professional brings to the industry. Perhaps, the main thing to be taken from the medical generalist role is the idea of extending the practice of holistic care. Even beyond the GP level, it is always important to continually assess the patient for changes in their condition and this should not all be left to the GP.
In order for the NHS to function well in the future, it is time for all of its professionals to share an equal burden in patient care.
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