Shila Begum is a GP in Manchester
Small, deliberate acts of attention — often overlooked — can significantly influence consultations, alongside clinical interventions. Sometimes a pause, a flicker of hesitation, or a subtle shift in posture signals something deeper — a fear, a worry, or a story that cannot easily be named. These fleeting, almost imperceptible moments often shape the encounter as much as any clinical intervention that follows.
Brief acts — listening fully, acknowledging uncertainty, pausing before responding — can deepen understanding and strengthen trust.
Yet these subtle moments point to a wider truth: care is not a finite resource, but an approach we bring to each interaction. Quietly shaping daily encounters, this approach to care may nurture resilience for both clinician and patient, enriching each connection.
This is not only about individual consultations. Care involves more than technical competence; it is also shaped by our approach. The way attention, intention, and ethical awareness are carried into interactions shapes relationships — with patients, learners, and family. Brief acts — listening fully, acknowledging uncertainty, pausing before responding — can deepen understanding and strengthen trust.
How care is brought to interactions remains consistent across many settings.
For me, this perspective has been reinforced beyond the clinic. In community teaching, capable learners stop submitting work, held back by hesitation rather than ability. Time spent understanding their perspectives reframes obstacles as they step forward. Listening with care, rather than focusing on instruction, shifts insight. The approach feels consistent: how care is applied makes a difference in both teaching and consulting.
Parenting offers similar lessons. Days hum with constant noise, yet connection often emerges during moments of deliberate attention — school drop-offs, walks home, and bedtime. Eye contact, touch, and listening to the full account of a football match — who kicked the ball into the tall hedge, the disappointment that followed, and what might happen tomorrow — can build trust. These moments suggest that similar approaches operate at home as they do with patients.
Ethical traditions, including bioethics, emphasise attentiveness, moral responsibility, and the approach we bring to each interaction as central to good care.1 Care is not only about treatment or clinical decisions, but about how a clinician listens, responds, and recognises the dignity and experience of the person before them. Attentiveness is therefore an ethical and practical obligation, guiding clinicians to notice what may not be said and respond with reflection.
Irshatazkology and self-awareness
Tazkiyah, rooted in the traditional science of purification and growth, focuses on refining character, intentions, and ethical awareness, showing how inner reflection shapes outward behaviour — a principle relevant to all clinicians seeking thoughtful, ethical practice. The reflective programme Irshatazkology builds on this, guiding practitioners to examine intention, character, and responsibility, and to cultivate sincerity, patience, and attentiveness.
Pausing to notice my own inner orientation — rarely addressed in standard medical training — allows me to respond more attentively to a patient’s unspoken concerns. Irshatazkology demonstrates that care involves not just performing tasks correctly, but also being mindful of how our presence, intentions, and responses may influence others.
It develops awareness of a clinician’s intentions and ethical awareness — often overlooked in standard training — and how these can influence the quality of care. I chose this programme because medical training focuses on what we think and do, but rarely on how our inner orientation shapes practice.
Pausing to notice my own inner orientation — rarely addressed in standard medical training — allows me to respond more attentively to a patient’s unspoken concerns.
This perspective aligns with established literature. Mindful practitioners attend non-judgmentally to mental and physical processes, enabling better listening, decision-making, and compassionate action.2 Yet, in the pace of everyday practice, such reflective approaches may easily be sidelined.
I do not always recognise these moments as they occur. Their significance often becomes apparent only in reflection. What I offer is an observation: the mindset and inner orientation we bring — in clinic, community, and home — quietly shapes every interaction.
My key takeaway
Quality care may not demand more time or resources, but it asks for focus and attention in our approach to care — noticing what is present, listening fully, and responding with intention — so that the person leaves feeling heard, respected, and cared for.
References
- Chamsi‑Pasha H, Al‑Bar MA. Contemporary Bioethics: Islamic Perspective. Springer; 2015. https://link.springer.com/book/10.1007/978-3-319-18428-9
- Epstein RM. Mindful Practice. JAMA. 1999;282(9):833–839. https://jamanetwork.com/journals/jama/article-abstract/191430
Featured Photo by Aniket Bhattacharya on Unsplash
