Yonder: a diverse selection of primary care relevant research stories from beyond the mainstream biomedical literature
Online feedback
Although the growth of online feedback for healthcare services has been celebrated for enhancing patient power and encouraging greater accountability, it has also been critiqued for being unrepresentative and undermining care relations. A research team from Oxford recently explored the relationship between online feedback and care improvement as articulated by patients and family members who provided feedback across different online platforms and social media in the UK.1 Online feedback was framed by participants as, ideally, a public and, in many cases, anonymous ‘conversation’ between service users and healthcare providers. These ‘conversations’ were thought of not only as having the potential to bring about tangible improvements to health care, but as in themselves constituting an improvement in care. The authors argue that the provision of online feedback can be understood as a form of care that is, simultaneously, both directed at health care (including patients, professionals, services, and organisations) and part of health care. They conceptualise this as ‘caring for care’.
Simulated telephone conversations
Whether certain British newspapers like it or not, telephone consultations are in many circumstances convenient and effective for patients and clinicians alike, and are undoubtedly here to stay. Given that authentic and properly supervised exposure of medical students to GP telephone consultations can be difficult to achieve in clinical placements, a team from Keele University have developed emergency telephone consultation clinics, which are simulated GP surgeries organised for final year students.2 In particular, they have expanded the range of patients presenting in these clinics by including trained, simulated patients requesting an urgent telephone consultation with a GP. They recently reported that this innovation has been highly successful, both in terms of logistical development and student feedback. The project began in 2016 but has, for obvious reasons, become even more critical in the last 2 years.
BMI
In recent decades, researchers, professionals, policymakers, and the public have become seemingly preoccupied with body size. The ability to quickly and easily measure body size using the body mass index (BMI), and then to produce categories like ‘overweight’ and ‘obesity’, has undoubtedly contributed to this fixation. A recent sociological review sought to ‘discuss ontological issues in how BMI is thought about and used’,3 highlighting a shift towards treating BMI as a measure of attained unhealthiness, rather than a probabilistic indicator of risk. As the study notes in its conclusion, our conceptualisation of BMI has tangible implications for how we prioritise care and how we pass judgement on who is considered to be a contributing member of society.
Grit
Grit refers to the combination of passion and perseverance for long-term goals and has become a recent topic of interest as the medical community grapples with issues like burnout. A research team from Tennessee recently conducted a review of the literature on grit in medicine,4 finding that grit appears to have a consistently protective effect on the development of burnout. Individuals with higher grit levels appear to have decreased levels of emotional exhaustion and depersonalisation, and higher levels of personal accomplishment. Although higher grit is associated with increased ‘wellbeing’, there is conflicting evidence on the influence of grit on performance metrics within medical training. Although the review is an interesting read, the authors’ suggestion that medical schools should consider introducing ‘programming or counselling for cultivating grit’, seems at best, naïve, and at worst, outright disturbing.
- © British Journal of General Practice 2021
