Comments on: Zen and the Art of General Practice

By: maura harvey

maura harvey — Sat, 08 Mar 2008 03:11:59 +0000

1. shopping list patients..ask for their list up front in the consult, then ocnsider yourself what’s urgent/related etc & arrnage what can be done today, & what carried over
2. those forms etc…..RNs are good at doing forms!!! delegate.
3. attitude…remenber it’s always the pt’s problem
4, focus….i mostly deal with interruptions at the time..so much easier than retracing/finding etc the person/message alter. my pt notes, or simply asking “where were we up to” regains my focus re the pt
5. laughter , anthropomorphizing/other simple analogies etc help pt compliance, comprehension & wellbeing….mine too!
6. quality coffee @ work
7. delegate more to RNs…they save my time…basic history, basic examination etc..use them as clinical assistants, educators etc = happy rn’s, smoother thru-put with less dr time stress. ideal.

By: Alan McCleary

Alan McCleary — Mon, 03 Mar 2008 03:45:52 +0000

Lists, Related to your “Time” When you are running behind because of the fracture, suture etc and the next patient sits themselves comfortably in the chair and says they have several things to talk about today. They then leave the most important one until last e.g. today’s central chest pain and just when you think you have got there they say ” And while I was here I thought you could have a look at (insert serious problem here). “

By: Keren Witcombe

Keren Witcombe — Mon, 03 Mar 2008 02:05:29 +0000

1. Problem: Trying to get beds for acute psychiatric emergancies.
Solution: according to GP liason psychiatric nurse one must send the patient to ED requesting an urgent assessment instead of making the assessment yourself. If you assess the patient as needing a bed, it is your problem to find a bed. If they make that assessment, then it is their problem to find a bed! Goes against the grain but saves hours of frustration.
2. Problem: Having patients sent home from ED with no explanation as to why they were not admitted and no investigation results.
Solution: GP Liason Doc to explain problem to ED and improve quality of discharge letters. Worked at our local.

By: Patrick Pong

Patrick Pong — Mon, 03 Mar 2008 00:29:33 +0000

Thanks Tony. I recognised the subject above. I will throw in this one I have problems with because it seems to be out of my control.

Other people’s paperwork (Rework in your list)

Centrelink and their forms create stress 90% of the time. Centrelink refuse or would not accept my sick note. Everybody else including our legal friends accept it as a legal piece of paper but Centrelink in it’s own world refuse to accept it and would send patients back for one of their sickness benefit note. How did this come about and why did we let it happened? I can carry on about Centrelink but I will not.

“My new employer wants a note for fitness to start work” but they don’t have relevant forms, sends my Zen crashing down. (I had one which needed me to certified a security officer mentally fit to carry a gun! After 20 years I still trying to understand how my wife thinks!)

This is the most difficult one for me in my daily work. I have tried Zen and it always comes back as FI “F@#&K it” instead of FTT.

Thanks for listening. That felt good.

By: Oliver Frank

Oliver Frank — Sun, 02 Mar 2008 21:47:47 +0000

Good stuff, Tony. I would like to respond to your first Zen zapper of Insufficent Time.

The most powerful thing I have heard about this is that we all have the same amount of time.

I got sick of always struggling to stay on time. My standard appointments are now half an hour. If a patient’s consultation takes less, I do some of the many other tasks that GPs always have in their in trays, or on their task lists on on their hipster PDAs, or I even occasionally sit and … think.

I am much more Zen like now.