Yonder: Choosing a GP, breast cancer, patient safety, and online dating

Ahmed Rashid is an academic clinical fellow in general practice at the University of Cambridge. He writes the regular monthly column “Yonder” in the BJGP: a diverse selection of primary care relevant research stories from beyond the mainstream biomedical literature. Twitter: @Dr_A_Rashid

You can download the PDF here at BJGP.org.

Choosing a GP.
The NHS constitution gives patients the right to choose the GP surgery they want to register at and to express a preference to see a particular doctor within that surgery. In a recent Australian study, researchers studied the factors that are taken into consideration when choosing a GP.¹ Their online survey was filled in by 2481 adults. The most important factor was care quality, which included technical and interpersonal care as well as continuity, and the authors felt the emphasis when publicising practices should be on the manner in which care is delivered, rather than the types of care that are available. Despite the important difference that cost is not a factor in the NHS (and is in the Australian health system), the study is a useful reminder that patient priorities must be central to the way practices are designed and promoted

Breast cancer.
Advances in breast cancer treatment mean even for those with metastatic disease, there is an increasingly long period of time between diagnosis and end of life. The uncertainty of living with metastatic breast cancer and the vulnerability to physical and psychological issues while living with this diagnosis prompted a group of researchers to investigate the information and support needs of this population, interviewing 18 women in total.² The results show that these patients deeply value relationships with health professionals, and in particular for this group, their oncologists. However, many women felt their clinicians did not appreciate the extent to which treatment side effects impact on quality of life. In addition, participants felt better supported when they had early breast cancer than following the diagnosis of metastatic disease. The authors suggest improving information provision specifically about advanced disease should therefore be a priority.

Patient safety. Vast numbers of patients are treated effectively and safely in general practice every day. However, among the complexity of consultations, prescriptions, visits, letters, and computer systems, the potential for patient safety issues is high. In recent years, there has been much focus on developing the right culture and systems to minimise the potential for harm. In a recent Globalization & Health study, a Leicester research team explored the views of health workers in low-income settings about the obstacles to ensuring patient safety.³ A total of 57 doctors, nurses, administrators, and managers from East Africa were interviewed. As is the case in high-income countries, front-line staff were able to provide valuable insights into patient safety challenges. It was particularly interesting to note that, despite the difference in material resources, key themes were remarkably similar to those in the NHS and included teamwork, professional hierarchies, and governance. This reaffirms that human factors, leadership, and culture really are central to embedding patient safety into any organisation.

Online dating. Evidence-based medicine approaches have helped to answer countless clinical questions and clarify some great mysteries of the medical world. Two clinical researchers from either side of the Atlantic Ocean recently decided to use a systematic review to find out whether there was an optimal, evidence-based approach to online dating.⁴ In order to do this, they searched the literature in a number of disciplines including psychology, sociology, and computer and behavioural sciences, finding 86 studies for inclusion. A desirable screen name (starting with a letter in the first half of the alphabet), an attractive still picture, and a fluent headline message are important to capture initial interest. Meanwhile, invitations to potential dates are most likely to be accepted if they contained short personalised messages addressing a trait mentioned in their profile, or extended genuine compliments. In the acknowledgements, the authors thank the potential dates who turned one of them down repeatedly and encouraged them to take this evidence-based approach!

References

1. Kenny P, De Abreu Lourenco R, Wong CY, et al. (Jan 7, 2015) Community preferences in general practice: important factors for choosing a general practitioner. Health Expect doi:10.1111/hex.12326, [Epub ahead of print].
2. Lewis S, Yee J, Kilbreath S, Willis K (2015) A qualitative study of women’s experiences of healthcare, treatment and support for metastatic breast cancer. Breast doi:10.1016/j.breast.2015.02.025, pii: S0960-9776(15)00040-5, [Epub ahead of print].
3. Aveling EL, Kayonga Y, Nega A, Dixon-Woods M (2015) Why is patient safety so hard in low-income countries? A qualitative study of healthcare workers’ views in two African hospitals. Globalization and Health 11:6.
4. Khan KS, Chaudhry S (2015) An evidence-based approach to an ancient pursuit: systematic review on converting online contact into a first date. Evid Based Med 20(2):48–56.