At the end of each day, a husband and wife have the ‘How was your day?’ conversation. He is a GP working in the Welsh valleys; she is a respiratory specialist registrar in a busy teaching hospital. Her stories tend to be vibrant and exciting, regarding such issues as ‘emergency pacing’, ‘thoracoscopy’ and the like. On the surface, his are more prosaic, as he tells her of the waiting room full of people who come to share the details of their often unhappy lives, with the vague hope that he may be able to offer some comfort in the form of support, medication, or referral. She suggests that he is acting more as a priest than a physician. She may have a point.
This paper intends to explore this view and to question whether the pastoral skills that good GPs must possess are sufficiently valued by other doctors, patients, medical teachers, as well as those who organise health service provision. We propose that the priest role is one of the many that good GPs need to appreciate and develop.
Historical perspective
The role of the present-day GP has evolved over time from that of an apothecary, who would sell ‘cures’ and dispense medical advice from his shop.2 In the days before effective treatments there was little else on offer bar pastoral support, listening, and advising. Perhaps this is where GPs have gained their status as important members of the community — a situation which we feel is still important to value.2
The role of the GP gained extra significance as the NHS came into existence when suddenly they were seen as the main provider and gatekeeper of free primary medical care in the UK. The role had not been investigated to any great extent until viewed from the perspective of …