We are losing the art of medicine

We are moving from medicine as an art, to medicine as an algorithm. Personalised patient care, empathy and the human touch are all increasingly seen as luxury extras, rather than the fundamental cornerstones of good clinical practice. Knowing and trusting your doctor should be the norm, and patients have every right to expect that.

The gradual decline of family doctors threatens the structure of primary care, treating patients as data points, rather than unique individuals to be cared for as such. A recent survey showed that nearly half, 47%, of adults who had been to see a doctor more than once in the last couple of years had never, or only rarely, seen the same individual.

Family doctors help to manage a patient’s overall health – for new issues, ongoing medical conditions and preventing future problems. Continuity of care is vital in providing a consistent and caring approach, enabling the doctor to treat the person, not just the symptom.

Losing that continuity is a failure of healthcare. Fewer family doctors means that care becomes more fragmented, with patients having to explain complex medical conditions/history every time they want to speak to a GP. This can lead to error, inconsistencies in treatment and a lack of a long term health strategy. All resulting in poorer health outcomes, therefore more doctor visits and more pressure on the health service.

A University of Cambridge study found that patients who see the same GP, are far less likely to need to return as often. In fact, this is as much as waiting 18% longer until they make their next appointment – spread across a health service treating millions, this is a significant reduction in demand. It found that if all GPs provided the same level of continuity as the best performing ten percent in England, that would mean 5% fewer consultations a year. In 2023, that would result in 17 million fewer doctor visits. Freeing up time for more consistency, and therefore better outcomes.

Family doctors play a vital role in preventive care, educating patients on health maintenance and implementing preventive measures with a personal touch. People know and trust a doctor they have seen for decades, so a gentle push to lose weight or cut down on the alcohol is received in the constructive spirit it is intended.

A recent YouGov poll found that 57% think that ‘it is important that they see the same GP each time they visit their local surgery’ – at Doctorcall, we’ve found it even higher than that.

Human relationships, and even friendships, matter. Many years ago, a patient came to me complaining of sporadic fainting – he had visited accident and emergency twice, alongside speaking with three other doctors as he travelled for work. After basic tests, it was put down to panic attacks. He knew something serious was wrong, and I believed him. Following an ultrasound of the heart, it was discovered that he had a tumour growing with parts occasionally coming apart leading to mini-strokes. It was only a matter of time before one big enough killed him. Surgery swiftly followed, and he made a full recovery. He takes me for lunch every year on the date of the procedure as a thank you – it’s always a highlight of my calendar.

Evidently, we don’t have enough doctors. But we must focus on immediately freeing up the time of our current workforce, sparing them mundane and unnecessary tasks which could be completed by assistants or even AI as a filtering system. There are boxes that can be ticked and referrals that can be made without needing a full appointment, but the option must always be available if the patient chooses.

The long term solution is to train more young men and women, but that means boosting medical school places in order to allow them to follow their dreams. This should be done now, not in 2031 as has been suggested. It will take ten years before the benefits begin to drip through, so the sooner we get started, the better.

It must not become the norm for a patient to expect a different face each time they wish to speak with a doctor. With population changes and technological advancements, healthcare is developing in ways far faster than many of us imagined even just a few years ago. Throughout that, the art of medicine must not be forgotten. As healthcare evolves, known, respected and liked family doctors must once again be central to how we deliver primary care in this country. Doctorcall is dedicated to providing that.

Dr Charles Levinson, 

Doctorcall Medical Director