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The human connection – are we missing a key in unlocking primary prevention?

Mariam Sohail is a locum GP in Lincolnshire

As someone in his late fifties who had never needed to see a doctor for decades, Mr Longlive* came across as surprisingly serious about his concerns about his borderline cholesterol. His research on best choice of statin was beyond impressive.

His research on best choice of statin was beyond impressive.

There was suddenly also a plan made to start iron tablets for a borderline anemia that had been stable for years. Our talk turned to his newly increased activity levels and dietary changes.

It didn’t stop at this. A series of queries then followed about nutrition supplements he is starting . I checked and rechecked his record for any recent cardiac history, asked about any alarming symptoms that may have triggered his health anxiety. There was absolutely nothing.

As we neared the end of our consultation, he revealed that although he was in his late fifties, he was now a father of a five month old baby. With a happy grin on his lips but an anxious concern in eyes, he expressed his wish to “be there” as his son grew.

I suddenly understood. Knowing the value of having a parent ‘being there’ for me, and being a parent myself, his words resonated with me. I couldn’t help but draw a comparison to how, when taking mental health history in depressed patients, we tend to check suicidal risk by asking about ‘protective factors’ or what would prevent them from ending their own life. This makes them think about the worth of their life to others. Why don’t we ever ask patients about who they want to live for, when discussing Q-risk scores and primary prevention?

Why don’t we ever ask patients about who they want to live for, when discussing Q-risk scores and primary prevention?

Most of us know patients with stories of successful smoking cessation or drastic weight loss, all done for sake of family members or loved ones. Maybe the interdependence between families and even communities can be used as a strength when it comes to health motivation.

As he walked out the room that day, I found myself sharing his enthusiasm for his long life. I was also struck by the realisation that I miss out on helping people find what can be the greatest motivating factor in primary prevention: loved ones.

*disclaimer

Name of patient and some case details are changed to protect patient confidentiality, and written consent has been obtained

Featured image by Ante Hamersmit on Unsplash

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