Volume 52, Issue 4, April 2023

More than what we prescribe

Brendon Evans   
doi: 10.31128/AJGP-04-23-5678e   |    Download article
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“Relationships matter: the currency for systemic change [is] trust, and trust comes through forming healthy working relationships. People, not programs, change people.”

– Dr Bruce D Perry1

In this April issue of AJGP, prescribing is addressed from differing perspectives. Quek et al approaches deprescribing in an elderly population,2 Aitcheson et al synthesise the efficacy of naltrexone in fibromyalgia,3 Eu et al investigate GP harm reduction in non-prescribed performance-enhancing drugs,4 and Ivers and Astell-Burt present the concept of prescribing time in nature to improve mental health.5 This variety of approaches is reflective of the breadth and depth of general practice.

However, the value and influence of general practice cannot be measured as a simple sum of prescriptions written and referrals made. The relationship built between a patient and ‘their doctor’ – often over years – is deeply impactful and unmatched among the specialties.

Relationships drive health outcomes. Strong patient engagement with their GP enhances quality of life, prevents hospital admissions, reduces healthcare costs, and improves mortality.6,7 It is the patient’s relationship with ‘their doctor’ that creates and perpetuates this engagement.

So, the next time a patient shows pictures of their grandchildren, motorbike or dog, know that this minute of personal connectedness is contributing to the trust and engagement that can be lifesaving.

We matter to our patients. Dr Meldrum shows this in this issue by highlighting the esteem held of general practice by the public, and our capacity to meet their healthcare needs.8 It is also evidenced by the expressions of gratitude received from those whom they have helped.

As GPs, we are more than what we prescribe. Our therapeutic relationship of trust is pivotal to our patient’s life story.

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  1. Perry BD, Szalavitz M. The boy who was raised as a dog and other stories from a child psychiatrist’s notebook: What traumatized children can teach us about loss, love, and healing. New York: Basic Books, 2007. Search PubMed
  2. Quek HW, Page A, Potter K, Etherton-Beer C. Deprescribing considerations for older people in general practice. Aust J Gen Pract 2023;52(4):173–80. Search PubMed
  3. Aitcheson N, Lin Z, Tynan K. Low-dose naltrexone in the treatment of fibromyalgia: A systematic review and narrative synthesis. Aust J Gen Pract 2023;52(4):189–95. Search PubMed
  4. Eu B, Dawe J, Dunn M, et al. Impact of harm reduction practice on the use of non-prescribed performance and image-enhancing drugs: The PUSH! Audit. Aust J Gen Pract 2023;52(4):197–202. Search PubMed
  5. Ivers R, Astell-Burt T. Nature Rx: Nature prescribing in general practice. Aust J Gen Pract 2023;52(4):183–87. Search PubMed
  6. Gronseth IM, Malterud K, Nilsen S. Why do doctors in Norway choose general practice and remain there? A qualitative study about motivational experiences. Scand J Prim Health Care 2020;38(2):184–91. doi: 10.1080/02813432.2020.1753348. Search PubMed
  7. Sandvik H, Hetlevik Ø, Blinkenberg J, Hunskaar S. Continuity in general practice as predictor of mortality, acute hospitalisation, and use of out-of-hours care: a registry-based observational study in Norway. Br J Gen Pract 2022;72(715):e84–90. doi: 10.3399/BJGP.2021.0340. Search PubMed
  8. Meldrum H. Public perceptions of general practice and the allocation of funds. Aust J Gen Pract 2023;52(4):169–70. Search PubMed

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