I feel a bit like an Ancient Egyptian right now. Ancient because I have returned back to my work as a GP following maternity leave, recent Covid, and a baby that still isn’t sleeping through the night. Egyptian because it feels like my life is governed by triangles.
Prior to my return I tried to ignore the current rhetoric that GPs do not want to see patients face to face and are lazy and overpaid. Whilst I only work very part time and am therefore protected from much of the pressures discussed it’s not great for the morale. I haven’t seen morale this low in the NHS before. I am therefore using the triangle’s we teach young people about on our programmed to try and not be distracted by this.
First off is Maslow’s hierarchy of needs. At the very base of this triangle lies the physical needs, i.e. you must meet these needs before you can move up to any of the other four levels. The apex of the triangle is self-actualization – i.e. being the best you can be. This reminds me of the acronym HALT – Hungry, Angry, Late or Tired. Being one of these four significantly increases the chances of human error which is important when you consider that 70% of plane crashes are due to human error. Recognition of this and steps to prevent pilots from being one of these means that aviation is now one of the safest ways to travel. Of course, a poor GP consult doesn’t lead to an entire plane going down, but I would estimate that 90% of complaints arise because a doctor doesn’t fully ‘see’ the patient because the basis physical needs of the consulting doctor and or patient are not being met.
The second triangle is Kartman’s drama triangle which describes dysfunctional transactions between people. One point of the triangle is the persecutor – the angry blaming one. Another point is the rescuer – the one that always comes to the rescue offering to fix things, sometimes at their own personal expense leading to burnout. What both of these roles have in common with each other is that they each hold a position of power and what they need in order to exist is a victim. The victim cries “Why me?” and by the very nature of the victim they are powerless. This means that any transaction is unequal. The other key thing is that anyone can move around this triangle and take up a different role. This seems to be what is happening in the NHS at the moment between patients, NHS professionals and politics/bureaucracy. Unfortunately, whilst this triangle exists, I fear the ones that will remain powerless are the patients.
Which leads me on to the government’s new initiative – the personalised care institute. In principle I think this is an excellent idea. It will employ health and wellbeing coaches to empower patients to become advocates for themselves which should result in equality within the doctor patient relationship.
Next time I will tell you about how GRIT will be involved in this new initiative and the exciting possibilities this brings. Just in case you are wondering what relevance GP and these triangles have to GRIT itself (apart from the fact that I am a GP and founded GRIT) the answer is that isn’t the point. The point is that these are the principles we teach young people on our programme, yet I, as an adult, use them to support me in my everyday working and personal life. I might not be able to run on time and I might be woken every night, but I can make sure I have breakfast and coffee before work. I can make an active choice to stay out of the drama triangle when I’m with my patients and focus on the exchange between us for those few minutes being one of equality and empowerment for there is no room for politics here. These are valuable skills I have learnt and that we teach. They are not just skills to help a ‘troubled teen’ but ones that we can all use for life.