A GP colleague of mine who retired 6 years ago died recently, leaving a suicide note. Initially, we felt disbelief and numbness, with huge sympathy for his widow and family. As I listened to tributes from family and former colleagues at his funeral, I remembered the man who was devoted to his family and to medicine, and who still made time for music and his love of the countryside.

So what makes a doctor really good at what he does? The General Medical Council defines a good doctor in Good Medical Practice.1 Sir Peter Rubin, commenting on the latest version of this guidance, says that doctors have the enormous privilege of touching and changing lives, and highlights five things that doctors do:2

  • synthesising incomplete and conflicting information to reach a diagnosis
  • dealing with uncertainty, for example where treating one condition may make another worse
  • managing risk and sharing information about this clearly with patients
  • recognising that society and medicine are constantly changing
  • carrying responsibility for actions.

We all do these things, sometimes to our satisfaction and sometimes as best we can in the circumstances. Every day in general practice, we manage patients using incomplete information, communicate clearly with them about risks and benefits, and invite them to contribute to decision-making. If all this sounds far removed from my friend, it is. He would have expressed it much more simply:

  • build up a good long-term understanding of, and with, the patients you see
  • be willing to work hard, and be consistent with patients
  • always do the best you can for your patients
  • always keep a good sense of humour with patients and colleagues alike
  • be willing to make others laugh.

My friend will be missed by many. I hope those of us coming to terms with his loss will learn from what he did.

Dr Honor Merriman, GP and CPD Tutor, Oxfordshire

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Osmosis is a smart application that allows clinicians to automatically record online educational activity in real-time, for the purposes of gathering CPD points. Its purpose is to make life easier for clinicians engaged in appraisals and revalidation: saving them time; encouraging lifelong learning; and taking the intrusive nature of appraisals out of the process.

Consider a typical consultation, in which the clinician may have to reference (for example) patient.co.uk, to provide a holistic service to the patient in question. The reference may be to mitigate a ‘patient’s unmet need’, or indeed, a ‘doctor’s educational need’, but once the website is closed and the patient has left, the clinician moves on to the next patient. Osmosis runs in the background, and allows any online activity to be recorded. This can be reflected on at the discretion of the clinician, in line with the GMC’s four Good Medical Practice domains. A report may then be generated, which can be uploaded for the purposes of appraisal and revalidation.

Osmosis is pre-loaded with a number of common ‘GP sites’ (patient.co.uk, NICE, etc), but the user can add their own sites to be tracked and it is compatible with most GP IT web browsers. For further information please visit: osmosis.me

Dr Junaid Bajwa, GP and CCG board member, Greenwich

Update your knowledge:

GP curriculum heading 3.13—Digestive health

To learn more about the role of GPs in testing for chronic hepatitis B and the secondary care treatment pathways for the condition, read the article here

  1. General Medical Council. Good medical practice. GMC, March 2013 (updated April 2014). Available at: www.gmc-uk.org/guidance/good_medical_practice.asp
  2. General Medical Council website. What makes a good doctor? Sir Peter Rubin, personal view. www.gmc-uk.org/guidance/10058.asp (accessed 29 May 2014).