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Living life in the slow lane

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I WAS overtaken more frequently than usual on my drive to work this morning. Admittedly, since attending a speed awareness course, I have been driving with more attention to street lighting, road signs and my speedometer, but while semi-flooded roads were the brake for me today, apparently, they were not for white van drivers or boy racers in Audis.

Is this allegorical? I pondered. I was considering a couple of cases I had been managing last week, up until I had a one-sided struggle with my dentist, who escaped with two thirds of my diseased molar. That took me off work for 24 hours and when I returned I found that, in my absence, my younger colleagues had ‘overtaken’ me. They had whisked both of the dogs away for CT scans and endoscopies. I was pretty sure the patients were on the way to recovery and, to my relief, the various diagnostics converted ‘pretty sure’ into ‘pretty jolly certain’ for both patients.

Interestingly, one client expressed extreme gratitude for the aggressive and sophisticated investigation, while the other grumbled incessantly about unnecessary cost – albeit with hindsight!

Was I right to have been trundling in the slow lane with these cases given that, in my opinion, they were showing signs of recovery, or should I have been more proactive in putting the diagnoses to bed? I think the clients’ respective responses demonstrated that either course of action was correct but that the treatment plans could have been formulated after a bit more client consultation. I might then have scanned one and not the other, according to the clients’ responses.

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There could now follow a diatribe about experience versus inexperience, or clinical acumen versus technology, but I won't go there. While I have been around long enough to have reasonable confidence in my clinical ability, I have also been fortunate enough to rub shoulders with specialists aided by high-powered facilities in a referral centre. That is where I learned that highly trained minds, supported by cutting edge technology, often discover disease conditions that could never have been guessed at clinically at a general practice level. The skill is to know all the options, manage client expectation and match it all to the needs of the case.

So on the whole I am comfortable trundling along the wet road of general practice, taking care not to slip into a ditch but, hopefully, also knowing when it is appropriate to put the foot down and ‘get a wriggle on’ as they used to say in Suffolk.

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