Catholic Medical Quarterly Volume 71(1) February 2021

The source and the summit of General Practice: takes us to the feet of Jesus

Dr Catherine Mangham

Dr ManghamThe Consultation is the source and summit of the profession of General Practice. We spend our whole career perfecting this connection with our patients. We have only a short time to connect, to exchange information and to evolve a plan of action to engage with the matter at hand. Both the clinician and the patient are fully engaged in this process. It is a partnership where effective communication is the milieu, the well, within which the work is done. Both parties supply and draw from this well. It is as deep or as shallow as the sum of the contributions.

It begins with the calling of a name, the observation of how the patient walks into the room, and the handshake. It continues with active listening. The patient is asked to elucidate the reason for their atten­dance. This helps to focus our minds. There may be many concerns and ongoing health problems, but the reason that the person has chosen to come for help that day is crucial. The articulation of the need at hand creates ownership of it. This initial exchange establishes a relationship of rights and responsibilities, openness and acceptance; a place where healing can occur. The physician then replies.

CrucifixionWe ask “What do you want?” and then we listen. We reflect back significant points that have been said, using the same language that they have been explained in. We meet the patient where they are, in their understanding of what is going on inside them and what their current needs are.

We accompany them on the journey of what has brought them to this point. We listen for as long as it takes to tell. We might summarise what we have heard and ask for confirmation that we have heard correctly. This is the loving response that in many cases is all that is required for healing to begin. The owning of a problem and the sharing of it and the being heard.

The physician may well have already a fairly good idea about what the problem might be, based on the call, the walk and the handshake, but there is a need also to hear what the concerns, ideas and expectations are, as well as to understand what the organic medical problem might be, which has triggered these concerns.

We need to know this because we are not only concerned with the organic disease but with the patient themselves. The cure will rely on a trusting relationship, as much as the right medication or surgical operation. The cure will also depend on the patient themselves believing in the cure and wanting to be well. They will need at some point to pick up their mattress and walk.

Perhaps it is starting to nudge your consciousness that the perfect medical consultation might echo a healing encounter with Jesus himself. Sadly, the perfect consultation is as elusive as heaven on earth, and the number of books written on the subject can attest to this. However, this echo has certainly resonated with me, as my desire to deepen my faith and my relationship with the triune God has gathered pace in recent years. It seems to me, that in so far as we are trying to love our patients, as Jesus would have loved them.. to want what is best for them... we can be a vehicle for extending His love to our fellow human beings.

It is uncanny that professional, psychological and philosophical research into the perfect consultation, pretty much takes us to the feet of Jesus. “What do you want?” Jn 1:38 “Jesus looked at him and loved him.” Mk 10/21 “Get up, pick up your mat and walk!” Jn 5:8 But to have the presence of mind and heart to realise the spiritual significance of every one of those consultations would be a truly awesome thing. Hopefully, if we have asked for His help, He will at least be making use of them while we are shuffling our papers.

Dr Catherine Mangham is a GP in Shropshire