Evolving General Practice during the Covid Pandemic

We reflect on the swift advancements that have come into place due to the covid pandemic propelling the evolving general practice

Evolving General Practice

Although general practice has been evolving slowly over the years, further swift advancements have come into place due to the covid pandemic. I reflect on what this means for me and for my colleagues. 

General Practice = Family Medicine

Traditional general practice was always otherwise referred to as family medicine; the care provided to a family over an extended period of time, enabling lasting relationships of continuity of care. There is a deep pride taken in the trust and rapport formed , which further enhances healthcare promotion and wellbeing in patients. 

This has largely been the case until more recent times. Smaller practices still thrive in knowing their patients well and the privilege this has. Larger practices still do hold on to the continuity of care as far as possible through access to named doctors. With increasing demand for appointments and increasing patient list sizes, continuity of care is becoming significantly more difficult. 

Given the technology boom, the introduction of telephone consultations, e-consultation, Skype and video consultation is not new. It has enabled a greater reach for busy practices, matching  demand for appointments and patient access to be met more readily. It has also allowed a greater control on the working day. I have personally enjoyed working in smaller practices and getting to know my patients over time. 

The deterioration of the doctor-patient relationship?

We are a profession attuned to visual, non verbal cues and visible clinical signs. Much information can be gained by seeing the patient face to face. It does, of course, also help build a more personal touch to the consultation;emotions are easily expressed and picked up visibly. This has been harder to gauge during telephone and even video consultations. It has certainly meant a greater need to refine auditory senses and more consideration to tonality and voice changes. Video consultations are an incredible resource but do not have the same flavour of a face to face consultation in terms of rapport building. 

The future of the evolving general practice

I ponder what lasting changes will occur during and after this pandemic. We have adapted to primarily rely on telephone and video consultations with reduced face-to-face contact for the present. For patient and staff safety, this may even be a lasting phenomena. Largely, conventional GP training and CSA exams are mainly reliant on face-to-face consultations. I wonder what this means for training in the future. 

General practice has done superbly well at managing multiple conditions as well as medical uncertainty. It has risen to the challenge and adapted new strategies and modes of working very quickly. Staff have overcome obstacles and connected effectively to provide the best service possible, in collaboration with community networks and secondary care colleagues. No doubt, it will continue to evolve as necessary. I wonder what features and traditions will remain the same and which will alter. 

I wonder how you feel about the continuing evolution of general practice?

For more reflections from doctors facing the pandemic, check out our Doctor Diaries.

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Dr Mehwish Sharif is a General Practitioner, Coach and keen writer. Special interests include clinical hypnotherapy and advocating for neurodiversity and inclusion.

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