I was trained in the art of traditional medicine. Five years at medical school. I was trained to make a diagnosis by taking a patient’s clinical history and by examining them. I was trained to request diagnostic tests and interpret them, and to refer to my colleagues for advice when I thought it was required. I was also trained to prescribe medication safely.
I have also trained to become a GP, and have spent the past 20 years practising as a family doctor and training junior doctors to become General Practitioners too. Being a GP is unique in medicine. Our curriculum is large, and we have to become adept at knowing a little bit about everything. We see our patients in our own surgeries and in our patients’ home. We meet their families and their friends, and we see them through the good times and the bad times. Cradle to grave. We treat everything with confidentiality and sometimes feel more like parish priests than medics. We also have to learn to see people over time and develop relationships with our patients, understand the ‘psychosocial’ elements and how they affect illness and behaviour. Sometimes we feel a bit powerless over these but we are trained to listen and offer support the best we know how. A lot is expected from us.
I’m proud to be a GP as I think it is a truly special job. I also think the time has come to have a fresh approach to general practice and think outside the box. Chronic disease, mental health, obesity rates are going up and up. The model we have is groaning under the demand. I am a GP appraiser, which means I get to speak to GPs from a diverse array of backgrounds in their annual two hour long meetings. This is a special role which I love doing. I am trained to guide GPs to present their evidence to show that they are complying with the GMC reaccreditation guidelines, but I also give them an opportunity to talk to a fellow colleague and reflect upon where they are now. I think it is a great opportunity to support GPs and give them space to talk and think about themselves for a change. They are good honest hard working people but many feel that something is missing and many of them are starting to develop a plan B and look for other ways to make their day-to-day jobs more workable for their patients and themselves.
Functional medicine is an extremely interesting concept that is big in the US and slowly making its way over to the UK. Many many doctors that I meet have not heard of functional medicine. To me, it feels like a genuinely interesting and exciting way to look at my patients’ symptoms and place them in the context of their individual lifestyles.
It is very different from the mainstream traditional model of medical specialities. I think it is a really useful and helpful model in which to manage chronic disease, in which we are facing huge demands. Traditional medicine is brilliant when there is a clear pathway, acute emergency or a single silver bullet easy solution. It is much more difficult when a patient’s problems are complex and involve more than one speciality and lifestyle factors are major contributing factors. We need to work with our patient and offer a practical solution and put diet and lifestyle at the heart of family medicine.
I’m coming to the end of a two-year journey in which I have had the privilege to be able to study nutrition and lifestyle factors and how they contribute to wellness and health from a functional medicine perspective. I don’t have the luxury of time to be able to move into my patients’ homes but I want to be able to simply apply some of the useful things I have learned. I suspect that will take some collaboration and help from other like-minded and trained people.
I want to see the two worlds of traditional medicine and functional medicine overlapping, colliding, talking, sharing, collaborating and being open minded. The only winners will be our patients and the only losers will be ourselves if we choose not to think outside the box.