Wednesday, November 27, 2013

The perception of reality


A break from the Game-changer series to reflect on something from last night.Twitter can be so amazing sometimes....one minute you are debating whether the NHS deserves an ideological shift, the other moment you are talking about the importance of early diagnosis of cerebral haemorrhages followed by in depth analysis of the latest slant on the eponymous Spider-Man storyline. And then again sometimes, you just be a voyeur and read some tweet threads.

Recently I sat through a fascinating thread where a few general practitioners debated the importance of public relations. I suspect on twitter we do have a self selected group who may not necessarily represent the vast majority but then again it does offer a sneak peek. Differences of opinions on this thread line were evident followed by one concluding that we shouldn't waste our time on such issues.
And even though I didn't jump in, I had to disagree. In the world we live in, like it or not, perception is key. A shrill continuous banging of drums opposing policies gets you pretty much no where. Let me give you some examples...for starters the Liverpool Care Pathway. We had twitter in an absolute meltdown and all of us who deal with End of life care felt this would not be beneficial. But instead of countering media versions, lots of folks went on the rhetoric, made very valid points...but in the end? the LCP doesn't exist any more. Recently a ward round drove home to me what we had lost...or more importantly what the patients had lost. As a profession we should have done better,we should have opposed the media with charm, our own public relations offensive..we didn't...we decided to depend on the rhetoric,pour out our emotions...end result? No one lost out except the patients and their families who deserved it.

Now let me give you the opposite example..in fact two of them...where good publicity, branding has helped to emphasise something which is so basic but yet so important. For starters, the 6C campaign...I will admit I was among the few who rolled my eyes at it. "Compassion"?? "Care"?? Why would you need to emphasise that? Surely that was fundamental to what nurses do? But over time, it has caught the imagination, it has focused the mind on something basic yet so important...and as the Julie Baileys of this world to ensure  will attest to, somewhere down the line, the basics were lost..so if it needs a catchy name to reclaim the ground, so be it. If thats what's needed to make a nurse stop for a second and get that glass of water closer to the elderly lady, then 3 cheers to branding, publicity and a charm offensive.  

Another one? Kate Grangers "Hello my name is....." campaign.Simple yet effective. Now I have had corridor conversations with colleagues who have found this campaign odd.."why is this even a campaign?", juniors who have felt this to be a stunt ( till they read and learn a bit more about Kate) but there is no denying its impact. It's the basic tenet of a healthcare professional, shows the ability to interact, be compassionate...and again, this campaign for sure has focused the mind on something inherent which somehow has been forgotten,somewhere in the mix lots have indeed forgotten the basics of human interaction..introducing yourself with a smile. Impact of branding and perception? Absolutely amazing.

So back to the concept of perception. Beating the shrill rhetoric of "hard working GPs", "there is no money", "we only live for the patient" maybe indeed your own personal preference and admirable practice but thats not representative of everyone. For every ten amazing GPs, there is also one who has the bottom line of his finances in his mind, who makes pride in the business and profits he runs..I have met them, shared a beer with them. Are they less caring? Not necessarily but neither are they on twitter saying they like their profit margins too.
So..suggestion? Be open, launch perhaps a charm offensive, maybe even come up with something catchy..explain to the public what pressures GP surgeries work to, why it is different , if at all, from a private enterprise..step away from words such as internal markets, qualified demand and talk in plains simple language that patients can understand.
It's a lot to do with perception...a specialist is as much Dr House as much as a GP is Doc Martin. Be proud of what you do, yes, excellence is and must be an everyday thing, it also is something that should be championed and highlighted with pride...dare I say the stiff British upper lip which holds back self praise could be resulting in losing the battle against a savvy media with its own agendas?

I can't preach to anyone, neither do I intend to but there are many ways of attaining what needs to be done for patient care, and I don't think rhetoric is the way ahead. A local example lies in the Super 6 diabetes model. The concept? "Specialists do only a few things in hospitals, rest is by education, virtual and face to face". Sounds like anything amazing? No it actually isn't..it's something we as trainees always chatted about over beers.
All we did was label it, package it, wrote some articles, won some prizes and boom Partha Kar was a "thought leader". No actually he isn't. He is still the brash chap he was, still making mistakes, still trying to do the best but lucky with an amazing team....doing stuff that others are trying...only difference? The perception of what we do...the showcasing of what we do..proudly. No longer in Portsmouth is a Diabetologist the mild mannered person who accepts anything thrown at them, but now it's a team which knows when to launch a charm offensive and when to snarl when patient needs are paramount..irrespective of whether the person at the other end is a Board member, fellow colleague or manager. We are not here to satisfy others egos or do their jobs, we are here to do the best for the patients.

We are here to do best for the patient,so to achieve that you use whatever tools you have in your armoury..and perception is paramount. Andre Agassi once said.."Image is everything"...maybe that's a stretch too far...but a combination of talent and passion , which the NHS has in abundance..combined with a better image...can and will be an electric one.

Primary care is the bedrock of the NHS and rather than the rhetoric, my suggestion would be to seize the initiative and be at the forefront...Gerada set the tone in her inimitable style....who's next to pick up the baton? Who's the one to launch the charm offensive to explain what being a GP means? And if you don't believe that its not needed, then look outside the window...the NHS is slipping away..fast...and if primary care cant save it, then I can assure you, no one can.

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