Why I like to get to know my patients (Rachel Hall)

I am passionate about getting to know my patients — I believe this continuity builds trust, gives me insight into their condition and helps with the shared decision-making process.

It also allows me to judge when to avoid over-investigating a problem in a patient known to be very anxious (since this can perpetuate the individual’s anxiety and be counterproductive).

One such patient is a woman who started seeing me after her cardiologist suggested changes to her heart medicines. She was so anxious that she could not tolerate any change to her therapy. She would ring me up after a couple of days with a list of relatively minor side effects from a new tablet and tell me she had stopped taking it. In the end, I admitted defeat and she remained on pretty much her original medicines.

Continuity of care gives clinicians a chance to develop a greater understanding of what is going on in their patients’ lives. A recent bereavement, stress at work or redundancy will, of course, have an impact on a person’s well-being and may be a possible cause of their current complaint.

One of my patients comes to see me, rather than one of the doctors, because she knows me from when I used to treat her mother before she died of cancer. She says she feels comfortable talking to me because I know what she has been through in recent years. Of course she is fully aware that, because I am not a doctor, I will not be able to help her with everything.

I have now been working at the surgery full time for over five years. During that time my role has evolved, from primary care trust pharmacist to pharmacist prescriber, and now a new position as clinical manager.

My latest role is well and truly imbedded into the practice. Its focus is on improving patient care both directly (through my clinical work) and indirectly (by improving our systems to ensure safe and effective practice), while managing an ever-increasing practice population.

I truly believe that the continuity of care general practice has to offer is unique; it simply cannot be replicated in the large, somewhat impersonal, polyclinics (although the latter model may work well in some areas, like London).

To my mind, continuity is paramount to achieve good outcomes for patients in a demanding and constantly changing healthcare environment. I get real satisfaction from getting to know my patients and, hopefully, being able to make a difference to their lives.

 

Rachel Hall is clinical pharmacist at The Old School Surgery, Bristol