Overview

An argument for attentive and personal care within the bureaucracy of health care systems. In Fighting for the Soul of General Practice, two practicing doctors share their experiences of working within the underfunded and highly bureaucratic health system in the United Kingdom. Drawing on years of experience treating a wide range of patients from all backgrounds, they show what is lost when regulation overrules relationships, standard practice eliminates discretion, and algorithms displace personal attention. While acknowledging that bureaucracy is inevitable and important, they argue for an approach to medicine that is about creating meaning for doctor and patient and that privileges connection, attention, and care within each encounter.  

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9781789388398

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Reviews

UK general practice is at a precarious crossroads. This book captures the essence of traditional, relationship-based, family doctor care, which is now under threat from a number of forces—not least the technologization of medicine and the inexorable encroachment of algorithmic, if-then decision-making on relational and narrative-based clinical method. At the very least, Shah and Foel have documented the essence of what we risk losing. Perhaps, if their warnings are heeded, they will also succeed in retaining and restoring what they rightly describe as general practice’s “soul”. -- Trish Greenhalgh With increasing bureaucracy, doctors struggle to take the life pressure [sic] of their patients. This book offers a compelling reflection on the importance of listening to patient stories as opposed to applying chilly algorithms for human care. The authors provide the reader with a lively under-the-rug inspection of street-level medical practice and the turbulent business of managing through bureaucratic demands.   -- Professor Paul Crawford, University of Nottingham, UK

'With increasing bureaucracy, doctors struggle to take the life pressure [sic] of their patients. This book offers a compelling reflection on the importance of listening to patient stories as opposed to applying chilly algorithms for human care. The authors provide the reader with a lively under-the-rug inspection of street-level medical practice and the turbulent business of managing through bureaucratic demands.' -- Professor Paul Crawford, University of Nottingham, UK 'UK general practice is at a precarious crossroads. This book captures the essence of traditional, relationship-based, family doctor care, which is now under threat from a number of forces—not least the technologization of medicine and the inexorable encroachment of algorithmic, if-then decision-making on relational and narrative-based clinical method. At the very least, Shah and Foell have documented the essence of what we risk losing. Perhaps, if their warnings are heeded, they will also succeed in retaining and restoring what they rightly describe as general practice’s “soul”.' -- Trish Greenhalgh 'This is an honest dispatch from the frontlines of the conflict between industrializing bureaucracies and the ongoing care of each person. It is a hopeful song for clinicians who, when the algorithm says no, breach the protocol and go the extra mile for each patient.' -- Victor M.Montori, professor of medicine at the Mayo Clinic. 'A rich, wonderful, profound and moving book. I was immersed in the many stories and heartfelt, sometimes harrowing, observations. The need to innovatively transform health and social care, and particularly mental health care, by integrating the work of primary care with social care, local councils, voluntary sectors, communities, patients and families is now vital. Written in an authentic and deeply compassionate way, Fighting for the Soul of General Practice provides a broad and comprehensive understanding of the issues and challenges we face.' -- Michael West, Professor of Organizational Psychology, Lancaster University Management School

Author Information

Rupal Shah is a GP in Inner City London and works as an Associate Dean for NHS England. As well as her many academic publications, she is a co-author of 'Our Mothers Ourselves', a memoir of mothering. Jens Foell is a practising GP and Academic, who is deliberately choosing to work in undifferentiated primary care rather than a specialist service. He has an interest in mental health, chronic pain and health policy and was also trained in rehabilitation and social medicine.

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