Repetition breeds contempt not continuity

Emilie Couchman is an academic GP, currently undertaking a PhD with the Mesothelioma UK Research Centre at the University of Sheffield and working as a GP on a part-time basis in Northumberland. Her Twitter handle is @DrEmilieCouch

“I have mesothelioma.”

These are words I hope I never have to say once in my lifetime, let alone every single time I encounter a healthcare professional.

Imagine having to relive the moment you are told that you have a life-limiting illness every time you need support; every time you feel vulnerable because of a physical or mental complaint that needs attention. Imagine having to experience someone’s reaction to the fact you have a life-limiting illness every time you ask for help. Perhaps a look of pity, an awkward silence because they are unsure of what to say, or as is often the case for those with mesothelioma, a blank expression from a healthcare professional who simply does not know what their diagnosis means.

This is one tangible, soul-destroying way that a lack of continuity affects such people. Continuity isn’t just ‘nice to have’, it is beneficial to the mental health of patients. They shouldn’t have to waste a single gram of energy worrying about the reaction of a healthcare professional every time they drop the bombshell of their diagnosis. Continuity allows them to retain their energy to support themselves, regardless of whether there is curative or palliative intent. It allows them to feel safe; to feel heard; to feel understood. It allows them to feel looked-after.

I firmly believe that the ‘good old days’ of the ‘family doctor’ are behind us. We can’t replicate this model within the current healthcare system. We cannot be what we want to be for patients in a ‘relational continuity’ sense. But my goodness, can’t we all spend a little time reading a patient’s notes before they enter our consulting room? Especially if it means that we might avoid adversely affecting their mental health by being ignorant to their situation. But of course, it isn’t as simple as that. Time isn’t factored into a primary care worker’s day for this ‘luxury’. Also, it requires everyone to work together to promote informational continuity; we need patient records to be updated correctly and as uniformly as possible. For example, people with a life-limiting condition could have an alert that pops up every time their record is opened. Patients are supposedly on the ‘Gold Standards Framework’ or the ‘palliative care register’. In my experience, this is often a tick box exercise; something that on a statistical level has significance, but that is often not palpable at the patient level.

What two tiny words can have a positive impact on a patient’s experience and increase subsequent trust in a healthcare professional?

Patient: “I have mesothelioma.”

Healthcare professional: “I know.”

Featured Photo by Glenn Carstens-Peters on Unsplash