Family Medicine

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References World Book of Family Medicine – European Edition 2015 GMC 'Good medical Practice' (2013) www.gmc-uk.org/guidance/good_medical_practice.asp mentoring.londondeanery.ac.uk/ NHS Thames Valley and Wessex Leadership Academy Mentoring scheme: Resource Pack 2012 Published by the Thames Valley and Wessex Leadership Academy Clutterbuck, D & Megginson, D, Mentoring Executives and Directors (1999) 120
World Book of Family Medicine – European Edition 2015 Andre Matalon, MD matalon@netvision.net.il 39 – Pleasures of Doctoring in Family Medicine Andre Matalon MD Dept. of Family Medicine, Rabin Medical Centre, Belinson Campus, and the Dept. of Family Medicine, Tel-Aviv University, Israel Co-authors Martine Granek-Catarivas MD (2) & Stanley Rabin PhD (3) (2) Dept. of Family Medicine, Tel- Aviv University and Clalit Health Services, Sharon-Shomron District (3) Dept. of Psychiatry, Soroka University Medical Centre, and Division of Psychiatry, Faculty for Health Sciences, Ben Gurion University of the Negev, Beersheba, Israel. Every day family physicians deal with difficult patients and difficult diseases, with disability and death. In many parts of the world, they face crowded waiting rooms, little time for each patient, disrupting telephone calls and financial and administrative pressures (1). Other pressures are those related to the doctors' own personalities such as perfectionism, self criticism, fear of failure or making mistakes or discomfort about uncertainty (2) (3). Feelings of helplessness or guilt are common among them (4). Doctors often feel overworked and under-supported and feelings of loneliness are also common (5). When family medicine is practised in a hostile environment with the threat of malpractice, doctors adopt a defensive position where their personal and professional well being is jeopardized, nibbling at their ability to enjoy their profession. But, in every simple day of work of any family physician, there are plenty of pleasurable moments, laughter, intimacy and closeness, moments of trust, compassion, love and warmth. Based on a qualitative review of Balint groups with residents (6) and on focus groups of tutors and specialists in family medicine, three themes could be identified regarding the pleasures of doctoring: the professional, emotional and contextual gratifications. Professional Gratification Family physicians expressed their enjoyment in practising holistic medicine, their ability to deal with almost all aspects of medicine, from cardiology through infectious diseases and psychiatry. This diversity guaranteed a continuous interest in their work. Some of the doctors expressed feelings of accomplishment when performing simple surgical procedures or actions that brought immediate relief from pain or disease. They described sharing the joy and prompt relief obtained after opening an abscess, excising an infected ingrown toenail or reducing a dislocated elbow. They expressed that there was no greater gratification than when the patient left the office without pain. Gratification was also felt in making a precise diagnosis, at the right time. This would happen especially when a diagnosis led to a dramatic change in the patient’s health, which further on, would also lead to a better doctor-patient relationship, recognition, respect and trust. To decide to treat difficult problems alone and succeed was also stated as immensely rewarding. The courage to treat difficult issues on one’s own, with the cooperation and full participation of the patient in the decision-making process was another source of much joy. Emotional Gratification We found a second group of expressions of emotional gratification that brought comfort and pleasure. 121
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Family Medicine

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