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Opinion

The first clinical decision of the day

"The phones start ringing before the shutters are fully up. On line three, a woman tries to sound calm but keeps losing her breath mid-sentence. The receptionist tilts their head, listening more to the rhythm than the words. Something isn’t right. The
15 April 2026
3 mins read

Doing it right, and doing it well

For us, perfection is not just an unachievable goal, but a false one, and perfectionism can never, even under ideal conditions, deliver the validation it promises us. Ben Hoban tackles perfectionism.
14 April 2026
4 mins read

Barriers and boundaries

Boundaries in medical care are therefore not primarily a mechanism for creating distance between people, but for making safe the closeness that effective care requires - not just the line separating one entity from another, but also the point of contact between
3 April 2026
5 mins read

Small acts. Deep knowing

Presence is not a soft skill. It is the core technology of general practice. In a world of algorithms and assembly lines, our most powerful clinical instrument remains our capacity to know our patients as human beings.
1 April 2026
4 mins read

Medicine’s caste system of the mind

"Both patients had the same symptoms and required the same care. However, one mind made the work smooth; the other made it onerous. Without malice or awareness, the GP sorted them into different moral categories: the organised mind that deserves time, and
25 March 2026
4 mins read

Time is the physics of care

"Time is not simply a tool for scheduling health care; it is the very medium through which care’s quality, safety, and justice are realised. It compresses attention, creates inertia, imposes thresholds, and dissipates energy. If we want to understand why care sometimes
18 March 2026
3 mins read

Fine. Thanks.

What if we were to let the patient into our own inner world; of battling against the clock, the relentless stacking up of admin that occurs in real time as the consultation progresses ... the lack of time in our relationships at
11 March 2026
2 mins read

I’m a GP — do you still trust me?

Trust is not visible, but you miss it when you lose it. Trust develops from many inputs that include memories, beliefs, and emotions that help us predict how someone may act.
7 March 2026
4 mins read
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A syllabus for whole-person medicine

Understanding the whole person also means understanding who and what affects that person - who and what enables and inhibits a person’s ability to respond creatively to the ups and downs of daily life. Such spheres of influence and their effects are
27 February 2026
4 mins read

Who decides what counts as illness?

Patients’ apologies for “wasting time” are not personal quirks but learned responses to a system that often treats unexplained symptoms as data rather than lived experience.
25 February 2026
3 mins read

Let’s just do some bloods…

Anyone can implement a protocol. Anyone can order a blood test. The real skill of a primary care clinician is in navigating the complexity and finding a helpful path forward for the unique individual in front of us.
23 February 2026
3 mins read

The consultation beneath the consultation

I almost missed it. My instinct was to dive into the prescription screen. But something in her silence caught me. I paused and softened my voice. “You seem like you’re carrying a lot today.”
20 February 2026
4 mins read
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