We were joined by over 300 of our GP, GP nurse, PCA colleagues and some admin staff, on one of those beautiful Autumn days where the sun shines, the leaves turn and a warm breeze blows, by the lake in O’Reilly Hall, UCD.
It was a day of reflection and renewal, a day where we thought about the challenges we have come through together over the past few years, the challenges that are yet to come and the current challenges we face. We heard about solutions and some wonderful self-care ideas, and throughout it all we considered the doctor patient relationship and how important it is for the patients and maybe for us.
The day started with the ever entertaining Professor Luke O’Neill who brought us from the NLPR3 molecule, that sounds like it should be an understudy for R2D2 (Star Wars) but instead is an important part of the inflammatory cascade caused by Covid (and other illnesses), right through to the future and ‘Dream Vaccines’ – if anyone can do this I think he can! How interesting in the face of all this advanced scientific knowledge that the basics of sleep enough/eat well/reduce stress and stay active are so important for boosting our immune system!
Dy John Wynn Jones brought us through the history of the Rural Doctor’s Associations culminating in the WONCA Rural Association- whose annual conference took place this year in Limerick. The Limerick Declaration states the actions needed to preserve Rural General practice into the future -especially important for us in Ireland with one of Europe’s largest rural based populations. He recommended a book called ‘A Fortunate Man- the Story of a Country Doctor’ which I will be hunting down.
We were delighted to be joined by Professor Abraham Verghese from Stanford University, an acclaimed author, and the recipient of multiple accolades, who spoke to us in his first talk of the day about the ritual of the exchange that takes place between doctor and patient in a consultation. He reminded us of the importance of the humanistic approach, especially in the face of the tsunami of digital medical informatics that is coming our way.
Some lovely quotations he gave us;
‘ ..the secret of quality is love’ Donabedian (a GP as it happens!)
‘Burnout is the sum of hundreds and thousands of tiny betrayals of purpose’ Gunderman
‘How we conduct ourselves is more important than any diploma’ Osler
‘The secret of the care of the patient, is in caring for the patient’ Peabody
Our own Dr Paul Carroll chaired a discussion on thought leadership, first hearing ideas from Dr Tim Haggett and Mr Marc Miller on how some of the challenges facing general practice have been addressed in other jurisdictions. Then he was joined by Prof Bury of UCD, who spoke to the academic work his department is doing in partnership with Centric, our own wonderful nurse lead, Marian Mulcahy, who spoke passionately about the unbelievable work she and her team have done to progress the SCOPE project in general practice with GP nurse training, supporting professional development, and the PCA training, and lastly Dr Donal Bailey spoke how HeartCare at Home could be a blueprint for proactively managing chronic illness and using technology as a tool to make that easier.
Dr Gerry Mansfield then chaired a discussion with myself and some key leaders for general practice in Ireland, Dr Diarmuid Quinlan, Medical Director of the ICGP, Dr David Hanlon, HSE National Clinical Advisor for Primary Care and Dr Maitiu O’Faolain, IMO GP committee representative. We discussed the challenges facing general practice and the current workforce crisis and some possible solutions, for example, expanding the scope of practice of clinicians especially the nurse and PCA roles, the addition of new team members such as Physicians Associates, opening pathways for suitably qualified non-EU graduates to specialist recognition. It was heartening to hear representatives of these key organisations speaking passionately about both the issues we face in general practice, and some potential answers.
We then had two spellbinding talks on self-care and the psychology of renewal. We heard from Dr Mark Rowe who reminded us that as much as we make our choices, more importantly ‘our choices make us’. He also talked about how to prioritise self-care saying ‘I take care of me for you and you take care of you for me’.
The psychologist and author Mr. Shane Martin, an ever engaging story teller and presenter, talked to us about renewal after the pandemic and again the importance of connections in our lives, both to nature and to other people. Just 2 hours a week of walking in nature leads to happiness (evidence-based study)!
We finished with Professor Verghese again, talking to us about the links between literature and medicine and how we, as clinicians, can learn from the tools of literature. The classic story narrative, from conflict, to crisis and eventually to resolution, is also often the narrative of our patient’s history and the consultation. The ‘epiphany’ of the story, that our own James Joyce wrote so well, is frequently the point we need to get to with our patients to reach some shared understanding.
We concluded the day with the Winners of the Paul Van der Merwe Awards-
- Clinical Person of the Year- Dr Dale Africa, Ennis
- Non-Clinical Person of the Year- Ms. Eilis Kaye, Innovation team
- Patient Centric Person of the Year- GP Nurse Martina Nelson, Hilltop, Drogheda
- Overall Winner- Dr Raimundas Zaveckis, Citywest.
The after party in The Royal Marine Dun Laoghaire was well attended, with lots of people throwing some serious shapes on the dance floor to the beat of the Metabollix, led by the multitalented Luke O’Neill. We were put to shame by the talent of our Dutch colleague Eugene on the saxophone who I think might be the bands newest recruit! Overall a great day with a real feeling of positivity permeating the talks and the festivities later. I left with a renewed feeling of hope for the future of General practice and a vow to get out for those nature walks more often (and who knows maybe dust off my old violin… but probably not..!).