I have just read this straight after the other piece and the comparison is so true and so stark. It what we are all seeing and have been seeing for a long time and no one at the top is listening..... and when its gone...it will be gone forever
Superb writing as always, it was a pleasure to follow your thoughts as you processed what continuity of care means. At least you were able to write it like that to allow others to understand despite your knowledge being far beyond the practical, single lived experience. That is a talent shared by outstanding teachers, I hope your work reaches a wider audience including student doctors, policy makers and bean counters.
Just read this immediately after 'what you can't measure' - the two work so well together in illustrating what's gone wrong in our healthcare system - thank you for writing such beautiful illustrations of what's going so wrong. And yet, those at the top continue to devalue the unmeasurable impact of true relational care and focus on the numbers. Makes no sense at all - we have all these impressive stats, figures and dashboards and yet the country's physical and emotional health continues to get worse and worse. When will they see this is just bad science and completely counter-productive?
What a horror story. The US healthcare system is equally broken...by design. Profits before people, inaccessible care, built-in biases that AI is only going to exacerbate. Hard on the docs and medical staff. Harder on the patients.
These two stories tell the bottom line for me and for my 87 year old mother and my kids and my grandchildren born this year. What mattered in the NHS - continuity of care with a GP trained to do the job I was trained for - is almost gone. It is going as I retire and those who follow are shoved screaming (usually metaphorically) into roles they did not train for and do not want. No wonder they are leaving UK practice in their droves to places that saw the GP as the jewel in the crown of the NHS - that saved money, saved lives, saved over medicalisation and over investigation and over treatment - and copied what we had. Why is access prioritised over continuity? Because it is measurable. But long term health outcomes are demonstrably, measurably, better with good continuity (not of record but of person).
We always had a sit and wait surgery where anyone urgent enough and prepared to wait could be seen that day - but people could also look at the waiting room and decide to come back tomorrow. Access was in many ways better then than it is now.
I have just read this straight after the other piece and the comparison is so true and so stark. It what we are all seeing and have been seeing for a long time and no one at the top is listening..... and when its gone...it will be gone forever
We are so close to this reality now and I expect the masses will applaud it, they won’t know what it isn’t until they need it
Superb writing as always, it was a pleasure to follow your thoughts as you processed what continuity of care means. At least you were able to write it like that to allow others to understand despite your knowledge being far beyond the practical, single lived experience. That is a talent shared by outstanding teachers, I hope your work reaches a wider audience including student doctors, policy makers and bean counters.
Just read this immediately after 'what you can't measure' - the two work so well together in illustrating what's gone wrong in our healthcare system - thank you for writing such beautiful illustrations of what's going so wrong. And yet, those at the top continue to devalue the unmeasurable impact of true relational care and focus on the numbers. Makes no sense at all - we have all these impressive stats, figures and dashboards and yet the country's physical and emotional health continues to get worse and worse. When will they see this is just bad science and completely counter-productive?
Thank you, i thought one without the other wasn't the best way to explain it
What a horror story. The US healthcare system is equally broken...by design. Profits before people, inaccessible care, built-in biases that AI is only going to exacerbate. Hard on the docs and medical staff. Harder on the patients.
Very honest and well written. So much has been lost.
These two stories tell the bottom line for me and for my 87 year old mother and my kids and my grandchildren born this year. What mattered in the NHS - continuity of care with a GP trained to do the job I was trained for - is almost gone. It is going as I retire and those who follow are shoved screaming (usually metaphorically) into roles they did not train for and do not want. No wonder they are leaving UK practice in their droves to places that saw the GP as the jewel in the crown of the NHS - that saved money, saved lives, saved over medicalisation and over investigation and over treatment - and copied what we had. Why is access prioritised over continuity? Because it is measurable. But long term health outcomes are demonstrably, measurably, better with good continuity (not of record but of person).
We always had a sit and wait surgery where anyone urgent enough and prepared to wait could be seen that day - but people could also look at the waiting room and decide to come back tomorrow. Access was in many ways better then than it is now.
What’s coming I don’t recognise as general practice. It’s something else, but I imagine it’ll be whitewashed with the GP label.