scholarly journals An established practice in new surroundings: concepts, challenges, pitfalls and guidelines for NCHD Balint Groups

2016 ◽  
Vol 34 (1) ◽  
pp. 1-5 ◽  
Author(s):  
L. Douglas ◽  
L. Feeney
Keyword(s):  
General Practice ◽  
Group Work ◽  
Group Leader ◽  
Balint Groups ◽  
The Face ◽  
Hospital Doctors

Balint groups are now mandatory for psychiatry trainees. Balint groups have been in existence in General Practice for several decades. Providing Balint groups for Psychiatry Non Consultant Hospital Doctors brings with it challenges for the group leader and participants. Many of these challenges are common place in any form of group work, while others are unique to this cohort. This article describes these challenges. Guidelines which offer the the group the best chance of success, in the face of these common challenges, are discussed.

scholarly journals Storytelling and poetry in the time of coronavirus

2020 ◽  
Vol 37 (4) ◽  
pp. 278-282
Author(s):  
Elizabeth Barrett ◽  
Melissa Dickson ◽  
Clare Hayes-Brady ◽  
Harriet Wheelock
Keyword(s):  
Group Work ◽  
Historical Context ◽  
National Study ◽  
Patient History ◽  
Current Crisis ◽  
Hospital Doctors ◽  
Balint Group

The coronavirus crisis occurs at a time when many clinicians have already experienced burnout. One in three Irish doctors were suffering from burnout in the 2019 National Study of Wellbeing of Hospital Doctors in Ireland; rates are also high in Irish Psychiatry. We present a perspective on the use of narrative in medicine and recognise that storytelling, and the patient history are very much at the heart of medicine. Clinician storytelling, such as Schwartz Rounds and Balint group work, has very much come to the fore in Irish Psychiatry and in training. Projects such as MindReading have explored overlaps between clinicians, humanities experts and experts by experience. We give an overview of some approaches from the movement around narrative in medicine to bolster this. We explore why clinicians write as ways to support identification, catharsis and a way to process experiences. Clinicians and patients may also use literature and poetry to promote coping. The historical context and practical strategies are highlighted, particularly with reference to poetry use during the current crisis.

The Doctor, His Patient and the Illness: Michael Balint

1989 ◽  
Vol 155 (01) ◽  
pp. 134-138
Author(s):  
Patrick C. Pietroni
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Balint Groups ◽  
New Entrants

Remembering where you were when Jack Kennedy died has become a favourite question to ask of people of an age to remember that day in November 1963. For a certain generation of general practitioners, a not dissimilar question might be, “When did you first read The Doctor, His Patient and the Illness?” Balint's impact on general practice is remarkable and unquestioned. His book, first published in 1957, appears among the top ten, if not the top three, that all new entrants into general practice ‘must read’. Yet the paradox is that few, if any, trainees will actually read his book, that Balint groups have a falling membership, that the Balint Society, founded after his death by a group of GPs, is on the periphery of modern general practice thinking, and that few if any permanent developments have come from his followers. Balint might well be excused if he paraphrased the quote attributed to Jung, “Thank God I'm Balint and not a Balintian”.

scholarly journals Email Consultations Between Patients and Doctors in Primary Care: Content Analysis

10.2196/18218 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e18218
Author(s):  
Helen Atherton ◽  
Anne-Marie Boylan ◽  
Abi Eccles ◽  
Joanna Fleming ◽  
Clare R Goyder ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Content Analysis ◽  
Communication Technologies ◽  
Face To Face ◽  
The United Kingdom ◽  
Wide Range ◽  
The Face ◽  
And Function

Background Increasingly, consultations in health care settings are conducted remotely using a range of communication technologies. Email allows for 2-way text-based communication, occurring asynchronously. Studies have explored the content and nature of email consultations to understand the use, structure, and function of email consultations. Most previous content analyses of email consultations in primary care settings have been conducted in North America, and these have shown that concerns and assumptions about how email consultations work have not been realized. There has not been a UK-based content analysis of email consultations. Objective This study aims to explore and delineate the content of consultations conducted via email in English general practice by conducting a content analysis of email consultations between general practitioners (GPs) and patients. Methods We conducted a content analysis of anonymized email consultations between GPs and patients in 2 general practices in the United Kingdom. We examined the descriptive elements of the correspondence to ascertain when the emails were sent, the number of emails in an email consultation, and the nature of the content. We used a normative approach to analyze the content of the email consultations to explore the use and function of email consultation. Results We obtained 100 email consultations from 85 patients, which totaled 262 individual emails. Most email users were older than 40 years, and over half of the users were male. The email consultations were mostly short and completed in a few days. Emails were mostly sent and received during the day. The emails were mostly clinical in content rather than administrative and covered a wide range of clinical presentations. There were 3 key themes to the use and function of the email consultations: the role of the GP and email consultation, the transactional nature of an email consultation, and the operationalization of an email consultation. Conclusions Most cases where emails are used to have a consultation with a patient in general practice have a shorter consultation, are clinical in nature, and are resolved quickly. GPs approach email consultations using key elements similar to that of the face-to-face consultation; however, using email consultations has the potential to alter the role of the GP, leading them to engage in more administrative tasks than usual. Email consultations were not a replacement for face-to-face consultations.

The effectiveness of telepsychiatry measured using the Health of the Nation Outcome Scale and the Mental Health Inventory

2003 ◽  
Vol 9 (1) ◽  
pp. 12-16 ◽  
Author(s):  
Craig Kennedy ◽  
Peter Yellowlees
Keyword(s):  
Mental Health ◽  
Health Outcome ◽  
General Practice ◽  
Initial Assessment ◽  
Face To Face ◽  
Significant Difference ◽  
Outcome Scores ◽  
The Face ◽  
One Year

In a telepsychiatry project in rural Queensland, data were collected from 124 patients attending hospital and general practice facilities for mental health-care and then again at follow-up one year later. Thirty-two of the patients were dealt with using telepsychiatry. Two health status scales were used to measure effectiveness: the Health of the Nation Outcome Scale (HoNOS), administered by the practitioners; and the Mental Health Inventory (MHI), which was self-administered by the patients. There was a significant difference between the initial assessment and follow-up groups on most subscales of the HoNOS, but no significant difference between the face-to-face and telepsychiatry groups. Similarly, the MHI results showed a significant difference on all subscales between the initial assessment and follow-up groups, but no significant difference between the face-to-face and telepsychiatry groups. Individuals who used and did not use telepsychiatry all had improved health outcome scores on the HoNOS and MHI during the study period. Telepsychiatry was as effective as face-to-face care.

scholarly journals Alternatives to the face-to-face consultation in general practice: focused ethnographic case study

2018 ◽  
Vol 68 (669) ◽  
pp. e293-e300 ◽  
Author(s):  
Helen Atherton ◽  
Heather Brant ◽  
Sue Ziebland ◽  
Annemieke Bikker ◽  
John Campbell ◽  
...  
Keyword(s):  
General Practice ◽  
Participant Observation ◽  
Health Issues ◽  
Ethnographic Case Study ◽  
Structured Interviews ◽  
Face To Face ◽  
The Face ◽  
General Practices ◽  
The One

BackgroundNHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives.AimTo understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice.Design and settingFocused ethnographic case studies took place in eight UK general practices between June 2015 and March 2016.MethodNon-participant observation, informal conversations with staff, and semi-structured interviews with staff and patients were conducted. Practice documents and protocols were reviewed. Data were analysed through charting and the ‘one sheet of paper’ mind-map method to identify the line of argument in each thematic report.ResultsCase study practices had different rationales for offering alternatives to the face-to-face consultation. Beliefs varied about which patients and health issues were suitable. Co-workers were often unaware of each other’s practice; for example, practice policies for use of e-consultations systems with patients were not known about or followed. Patients reported benefits including convenience and access. Staff and some patients regarded the face-to-face consultation as the ideal.ConclusionExperience of implementing alternatives to the face-to-face consultation suggests that changes in patient access and staff workload may be both modest and gradual. Practices planning to implement them should consider carefully their reasons for doing so and involve the whole practice team.

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