TOP TIPS FOR BEING A GP IN DEPRIVATION
These tips have been written to help you in your day to day work as a GP in a deprived area.
Look for the story behind the story. Presenting symptoms are often not purely medical and there is likely much more to the presentation, don’t be afraid to delve.
Build trust. Sort the small things that the patient asks you to sort first and build trust, - write the letter to housing, sign forms, (– you may be the only person they can ask to sign them) – don’t be tight and charge instead build up a bank of good will and trust.….. then……. Spend it on the things you want your patients to do but they are reluctant – spend it getting the smear test done, the dementia assessment, the childhood vaccs etc.
Work in partnership- your patients are complicated – they and YOU need help and support, any thing and everything. Find out who the troubled family workers are, find out where the local debt advise centre is, find out where you can get free parenting or children's activities, find out what voluntary sector organisations are around and what they do. Where is the food bank, how can you get a fridge, a buggy….etc etc … . You need all the help you can get.
Don’t underestimate the power of social contact- encourage patients to make friends, do something at your surgery to help foster friendships be it a monthly coffee morning, a choir, knit, natter and chatter group.
Look for the invisible. Start with the computer- search for those who have not been seen for years, search for those who have not had a smear, or immunization or vaccination, look for households with multiple people living in them, or addresses with multiple people these are likely to be probation, homeless or temporary housing addresses.
Find the other professionals in the area, the head teacher, the PCSO, the housing officer you will share common patients and get a fuller picture.
Bend main stream services to meet your patient needs- many services are commissioned to do domiciliary visits or offer alternative access- find out if they do and ask it for your patients.
Be the best doctor you can be, your patients need good- learn more medicine, get good relationships with consultants so you can get good advice, accept your patients will DNA outpatients appointments and agree a plan with secondary care for when this happens. (And not – They need to be re-referred through the gateway)
Remember your patients are expert survivalists – use this attribute to bring behavior change. Praise the good, celebrate progress however small, shower them in positivity. Use the neighbour tactic of , ‘ I had a patient who once……’
HAVE A HOLIDAY! TAKE A BREAK! KEEP A HOBBY! HAVE A LAUGH! FIND A FRIEND TO WALK THE PATH WITH YOU. Remember working in deprivation is a marathon not a sprint. Keep yourself and your team well.