John Launer: How to be a chronicologist

Although nearly all my clinical career has been in primary care, my work these days brings me into quite a lot of contact with hospital consultants. I’m involved in teaching them the skills for supervising juniors on complex cases, and so I sometimes have conversations with the consultants about such cases. I usually have only a fraction of the specialist knowledge the consultants do, but I can draw on my experience as a GP in managing uncertainty, dealing with the social, psychological, and ethical aspects of medicine, and having to navigate the dynamics of teams and wider systems.I’m often struck by fundamental similarities between the work of GPs and specialists. Contrary to what medical textbooks describe, both branches of medicine see large numbers of patients for whom there is no clear diagnosis or single ideal treatment. GPs often complain about referring patients to hospital only to have them discharged inconclusively,…
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