Skip to main content

Main menu

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • BJGP LIFE
  • MORE
    • About BJGP
    • Conference
    • Advertising
    • eLetters
    • Alerts
    • Video
    • Audio
    • Librarian information
    • Resilience
    • COVID-19 Clinical Solutions
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers

User menu

  • Subscriptions
  • Alerts
  • Log in
  • Log out

Search

  • Advanced search
British Journal of General Practice
Intended for Healthcare Professionals
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
  • Subscriptions
  • Alerts
  • Log in
  • Follow bjgp on Twitter
  • Visit bjgp on Facebook
  • Blog
  • Listen to BJGP podcast
  • Subscribe BJGP on YouTube
Intended for Healthcare Professionals
British Journal of General Practice

Advanced Search

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • BJGP LIFE
  • MORE
    • About BJGP
    • Conference
    • Advertising
    • eLetters
    • Alerts
    • Video
    • Audio
    • Librarian information
    • Resilience
    • COVID-19 Clinical Solutions
Life & Times

Travelling companions: a story told by a patient and her doctor

Rose Lamont, Tana Fishman and Felicity Goodyear-Smith
British Journal of General Practice 2018; 68 (671): 282. DOI: https://doi.org/10.3399/bjgp18X696425
Rose Lamont
University of Auckland, New Zealand; Te Huinga Raukura ki Manurewa, South Auckland, New Zealand. Email:
Roles: Resource Teacher Learning and Behaviour
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: rosemarielamo@gmail.com
Tana Fishman
Department of General Practice & Primary Health Care, University of Auckland, New Zealand; Clinical Director, Alliance Health Plus; GP, Greenstone Family Clinic, South Auckland, New Zealand. Email:
Roles: Honorary Senior Lecturer
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: TanaF@alliancehealth.org.nz
Felicity Goodyear-Smith
Department of General Practice & Primary Health Care, University of Auckland, Auckland, New Zealand. Email:
Roles: Head of Department
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: f.goodyear-smith@auckland.ac.nz
  • Article
  • Info
  • eLetters
  • PDF
Loading

BACKGROUND

The Patient and Clinician Engagement (PaCE) project1 involves collaborative dyads of North American patients and their family physicians/GPs working with university academics on participatory research projects to reduce disparities and improve community-based health outcomes.2 PaCE dyads meet annually at the North American Primary Care Research Group (NAPCRG) conference.

Felicity:

In my role as NAPCRG International Committee Chair, and Department Head of General Practice, University of Auckland, I initiated the first non-North American PaCE dyad. I approached my colleague Dr Tana Fishman, who in turn invited Rose Lamont, a patient of Pacific descent with whom she had a long-established doctor–patient relationship, to form their dyad. In November 2016 they travelled to the PaCE meeting at NAPCRG. This article describes their journey and its implications with respect to professional boundaries between doctors and their patients.

MEETING UP

Tana:

Travelling to the airport to meet Rose felt very unusual. It was difficult explaining to colleagues and friends that I was travelling with my patient. I worried about maintaining professional boundaries and appropriate self-disclosure,3 behaviours I had incorporated into my general practice for years. I was cautious. I did not consider Rose a friend, and had no connected associations with her. Why I chose her I still understand poorly, except that I knew she was intelligent, caring, and grounded.

I was acutely aware to ensure that Rose felt safe and was an equal partner in our decision making. Rose, an intermediate school teacher with a Master’s degree in education, was born in South Auckland to native-born Samoan parents. In Samoan culture, respect for parents, elders, chiefs, ministers, and doctors is woven within the fabric of society and posed a possible power imbalance issue. This cultural understanding is practised abroad wherever Samoan people reside and patients respectfully follow the recommendations of doctors without question. This contrasts dramatically with the philosophy of PaCE, where patients and doctors share an equal partnership.

My role was to help Rose make sense of the medical and research aspects of the conference and answer questions. Her unique approach to health seen through a school teacher’s lens attracted interest from other dyads. It was clear that Rose held enormous knowledge about the Pacific community and the socioeconomic determinants of health.

Travelling together included sharing meals, exercise opportunities, tourist attractions, group discussions, costs, our opinions, and our personal lives. This resulted in a partnership with equality of power and decision making, and the boundaries of our patient–clinician relationship clearly shifted.

Rose:

I was very hesitant when considering my participation in this project. I am a school teacher; how can I contribute to anything medical? I was worried about being called on for an opinion and not knowing what to say unless it related to education. I felt nervous but also excited to be the first New Zealand patient involved in such a project.

I had known Tana many years professionally but not personally. Meeting up at the airport, I felt comfortable to be travelling with her. She was easygoing. Initially the PaCE meeting was overwhelming and I felt lost. I had trouble grasping what it was all about and it seemed everyone else knew each other. Tana looked after me. As I met other dyads, I sometimes couldn’t immediately tell who was the doctor and who was the patient. I found their stories inspirational.

If Tana had maintained her professional distance, I would not have been comfortable, and the experience would not have been so valuable. Because we had shared about our families and our personal lives, I was able to be honest whenever I did not understand and to ask questions. During the conference I engaged in robust discussions about healthcare delivery, and began to learn the basic tenets of primary care research. In my role as a school teacher I have seen first-hand the health inequities of the Pacific population in South Auckland. This seemed like a way to do something about this.

Felicity:

Rose and Tana returned to New Zealand inspired. They focused on the health disparities of South Auckland, an area associated with deprivation, crime, and violence, but also very cosmopolitan with a thriving multi-ethnic culture and a centre of hip hop. It became their joint mission to make a difference in their shared communities of engagement.

AND NOW

Rose has recruited a Pacific Peoples Health Advisory Group (PPHAG), which includes school teachers, university students, a credit union manager, and social workers. In association with a Pacific-led primary health organisation they plan a ‘fono’ (assembly) to meet with primary health researchers as future partners for community-based research.

PPHAG members acknowledge that they are a consumer group but want an active voice and shared decision making; a shift away from representation. This PaCE project will propel the Pacific people from being passive recipients of health care to having equal voice and power. This shift in doctor–patient boundaries may also be early steps for the future of improved healthcare delivery models. The journey continues.

Acknowledgments

We wish to thank NAPCRG and the PaCE project for this unique opportunity.

  • © British Journal of General Practice 2018

REFERENCES

  1. ↵
    1. Sand J,
    2. Felzien M,
    3. Haeme R,
    4. et al.
    (2017) The North American Primary Care Research Group’s Patient and Clinician Engagement Program (PaCE): demystifying patient engagement through a dyad model. Fam Pract 34(3):285–289.
    OpenUrl
  2. ↵
    1. Tapp H,
    2. White L,
    3. Steuerwald M,
    4. et al.
    (2013) Use of community-based participatory research in primary care to improve healthcare outcomes and disparities in care. J Comp Effect Res 2(4):405–419.
    OpenUrl
  3. ↵
    1. Lussier MT,
    2. Richard C
    (2007) Communication tips. Self-disclosure during medical encounters. Can Fam Physician 53(3):421–422.
    OpenUrlFREE Full Text
Back to top
Previous ArticleNext Article

In this issue

British Journal of General Practice: 68 (671)
British Journal of General Practice
Vol. 68, Issue 671
June 2018
  • Table of Contents
  • Index by author
Download PDF
Article Alerts
Or,
sign in or create an account with your email address
Email Article

Thank you for recommending British Journal of General Practice.

NOTE: We only request your email address so that the person to whom you are recommending the page knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Travelling companions: a story told by a patient and her doctor
(Your Name) has forwarded a page to you from British Journal of General Practice
(Your Name) thought you would like to see this page from British Journal of General Practice.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Travelling companions: a story told by a patient and her doctor
Rose Lamont, Tana Fishman, Felicity Goodyear-Smith
British Journal of General Practice 2018; 68 (671): 282. DOI: 10.3399/bjgp18X696425

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Travelling companions: a story told by a patient and her doctor
Rose Lamont, Tana Fishman, Felicity Goodyear-Smith
British Journal of General Practice 2018; 68 (671): 282. DOI: 10.3399/bjgp18X696425
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Mendeley logo Mendeley

Jump to section

  • Top
  • Article
    • BACKGROUND
    • MEETING UP
    • AND NOW
    • Acknowledgments
    • REFERENCES
  • Info
  • eLetters
  • PDF

More in this TOC Section

  • The Last King of Scotland: using film to explore our understanding of professionalism
  • Medical education and war in Ukraine
  • Where I end and you begin: additional roles in British general practice
Show more Life & Times

Related Articles

Cited By...

Intended for Healthcare Professionals

BJGP Life

BJGP Open

 

@BJGPjournal's Likes on Twitter

 
 

British Journal of General Practice

NAVIGATE

  • Home
  • Current Issue
  • All Issues
  • Online First
  • Authors & reviewers

RCGP

  • BJGP for RCGP members
  • BJGP Open
  • RCGP eLearning
  • InnovAiT Journal
  • Jobs and careers

MY ACCOUNT

  • RCGP members' login
  • Subscriber login
  • Activate subscription
  • Terms and conditions

NEWS AND UPDATES

  • About BJGP
  • Alerts
  • RSS feeds
  • Facebook
  • Twitter

AUTHORS & REVIEWERS

  • Submit an article
  • Writing for BJGP: research
  • Writing for BJGP: other sections
  • BJGP editorial process & policies
  • BJGP ethical guidelines
  • Peer review for BJGP

CUSTOMER SERVICES

  • Advertising
  • Contact subscription agent
  • Copyright
  • Librarian information

CONTRIBUTE

  • BJGP Life
  • eLetters
  • Feedback

CONTACT US

BJGP Journal Office
RCGP
30 Euston Square
London NW1 2FB
Tel: +44 (0)20 3188 7400
Email: journal@rcgp.org.uk

British Journal of General Practice is an editorially-independent publication of the Royal College of General Practitioners
© 2022 British Journal of General Practice

Print ISSN: 0960-1643
Online ISSN: 1478-5242