GPs in Kerry, Wicklow and Dublin on patient expectations, acute pressures and the way forward
In September 1996, James McCormick, a GP and emeritus professor in the department of community health at Trinity College Dublin, had an article published“In the past 30 years the doctor as a father figure has become unfashionable and derided and is even seen as unethical. Yet the doctor as plumber denies some of the fundamental needs of those who are, or believe themselves to be, sick.”
“The first thing to say is that the patient population is more demanding now. And we have a lot of vulnerable people in our communities. But I would be absolutely passionate about keeping the role of the personal doctor because I think that is the model of perfection. You see Dr X; you get on with them and each consultation is a continuum of the previous. You don’t have to start again. We know from all studies that patients get better outcomes and doctors better satisfaction.
His grandfather worked during a period when tuberculosis was a prevailing health concern and when, prior to Noël Browne’s Mother and Child Scheme, figures for maternal and perinatal mortality were “horrendous”. Gastric problems were common, often the result of appalling dental hygiene. “Damp houses were another factor,” he says. Both his father and grandfather had surgeries in their homes. “It was just the norm,” he says of growing up in that environment.
“A big part is work-life balance. My father worked 12-hour days, five and six days a week for most of his life. People aren’t prepared to be available like that any more.” In Churchtown, Dublin, Dr Knut Moe is usually in his surgery at 8.30am after dropping his children to school. He runs his practice with his wife, Hana Maka, also a doctor. A three-hour session of seeing patients usually runs over by at least half an hour. “If you have a mental health presentation, then you give that patient the time they need. And then you see the faces staring at you in the waiting room. People have busy days. Waiting is not ideal for them.
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