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Achieving excellence in GP healthcare by being a ‘privileged listener’
Bundaberg based GP and James Cook University GP Training Senior Fellow, Dr Denise Powell, says her 40+ year working life can best be described as fulfilling the role of a ‘privileged listener’.
“As I reflect back on my years as a community-based GP, I have come to see my role more and more as that of a ‘privileged listener’ to my patient’s lives. The phrase has become my mantra and helps me to remember that there is real value in just simply being there for a patient.
“Certainly, for junior doctors nowadays, their training in handling the mental health side of patient care is more emphasised, likewise the importance of having conversations around a patient’s access to social and/or psychological support. But I think for me it has always been the way I have practiced GP medicine.”
“As well as the anatomical, physiological and pathological aspects of the patients I see, I’ve always been interested in the connection between the body and mind, and also something else not quite defined, such as the connection to others and the world or environment around us.
“When you live in small communities and have been in practice for over 30 years in the same town like I have, you definitely see that it is not just the physical characteristics that are inherited, but also the behaviour patterns gained in part from external influences that are inherited, and how that can impact people’s health; the nurturing that maybe some people did not receive, and the way that has affected the problems they may be experiencing.”
The phrase ‘privileged listener’ was first coined by American doctor Bernie Siegal in 1986 in his book Love, Medicine and Miracles and according to Denise, has made a huge difference to the work she does.
“I have found that when a patient feels comfortable and listened to, they open up more and give you more information which in turn, can make a huge difference to their treatment and ultimately health outcomes.
“The other important thing I have found from framing my work in this way is that it reminds you that you don’t always have to immediately fix things and it’s OK to not always know the answer straight away.
“Just by listening, providing a safe zone, and of course being the GP doctor who does the follow up, you're actually letting the patient work their own problems out, which can be hugely beneficial to their health in the long run.”
As a Senior Fellow, Dr Powell also provides support and guidance to JCU GP supervisors and medical educators. Her outstanding service to both medical education and to her local community of Bundaberg saw Denise being awarded RACGP’s top rural accolade in 2017, the Brian Williams Award. The award acknowledged Denise both for her dedication to her patients and their families and for her passion for general practice education.
“I must say that when I received the award, I thought they had got the wrong person! I felt like I was an imposter, in that I didn’t particularly want to be acknowledged as I just think there are so many other doctors also worthy of such recognition.
“JCU has been wonderful in giving myself and my colleagues, roles as Senior Fellows. We feel honoured by having the opportunity to give back to the new generation of GPs in training.”
Denise’s continuing studies throughout her GP career and commitment to her own professional development are also evidence of the dedication she has towards her craft.
“I think the need to know more fully about what your patients are presenting with, is what drives all GPs. If there is an area of medicine that keeps popping up in my patient group day after day, then naturally I want to know more about it. It’s what keeps the job interesting as well.
“So, my interests have changed as I’ve gone through different life stages with my patient groups also changing. I’ve completed further studies in breast medicine, nutrition, a Master’s degree in the academic basis of family medicine but what is now termed general practice, as well as doing courses on the training of health professionals, lifestyle medicine, and even meditation teaching. On my current trajectory, I will most likely undertake further studies into healthy ageing, palliative care and dementia care.”
For doctors who are considering the rural GP career pathway, Denise has some very sage advice to offer as gleaned from her long-standing career.
“We know that rural GPs are a very resilient lot. But even so, when you are in your junior doctor years, you can be at very high risk of feeling fairly diminished by your lack of experience or knowledge.
“In addition, the medical legal pressures of getting everything right can become a huge burden, as well as the higher expectations from patients without any more time allocated or funded. All of those things are capable of causing pessimism, both in your early years and throughout your career, and so is something I am very mindful of when mentoring registrars.
“Above all, I think it is important to try to stay positive and be optimistic in the knowledge that people in general are amazingly resilient themselves.”