At this point in history, continuing to do the work of a GP feels like a radical act. As a profession we are not immune to being swept along by strong cultural currents. We can be quite a traditional profession at times, but our contact with patients from any and all walks of life, and the stories we hear of their experiences and resilience, and our professional responsibility to work for their best interests feels radical, as the times have moved around us.
First of all, we tend to be grounded in reality. We owe it to our patients to actually try to work out what is causing their symptoms, and what treatments are likely to be most effective at settling them, and what the likely consequences are of different courses of action. We have a general agreement that those sort of questions are best answered by the scientific method, and all that that entails. Yes, we’ll have disagreements over the exact interpretations of the science, but we tend not to seek out blog posts that confirm our preconceived notions as a way of learning new treatments.
This feels radical in the current political climate, where sources are chosen and facts are picked based on their alignment with our own political values. We are in a world of ‘alternative facts’ or ‘truth isn’t truth’, where prime ministers and presidents can lie, be caught, and not suffer any political consequences, because the first question people ask before supporting or condemning is ‘Are they on our side?’
Facts still matter for us. We are still tethered to reality, because there are consequences for our patients and ourselves if we ignore facts. ‘You haven’t got cancer’ will never be good enough if the biopsy shows otherwise. This would remain the case even if blog posts, Twitter arguments, or radio shock jocks shout loudly about it being untrue.
More importantly, perhaps, that very attitude of seeing anyone who comes into our room asking for help seems radical. Whatever their political views, whatever their skin colour or religion, even if they have done something that we disagree with or disapprove of, we will still see them and listen to them. That’s not to say we will condone or justify, or refuse to challenge them, but there will be a real dialogue with someone who is human. We refuse to boil our patients down to a single characteristic that makes a patient ‘us’ or ‘them’.
We can contrast this with the performative rhetoric of politicians and followers of politics, which doesn’t involve debate or discussion, only shouting across the barricades to satisfy their own supporters.
Worse, in the UK, in Australia, in the US, we see people being deliberately harmed to further party political gain. In Australia, our cruel offshore detention policies have been taken up by far-right parties of other countries. Policies to demean those on welfare are going ahead in the UK and Australia. Both the US and Australia are increasingly questioning people’s citizenship and right to contribute to a country’s democratic debate on the basis of skin colour.
I never thought I’d see a time where connection to facts, and connection to other human beings, especially humans different from ourselves, could be viewed as radical. But it feels like that is where we are, and GPs and practice staff across the world should be proud of these principles. We are still among the most trusted of professions, and our consulting rooms may become not just places of healing but also places of sanctuary.
- © British Journal of General Practice 2019