Author: George Zaharias
Australia: McGraw Hill Education Pty Ltd, 2025
Paperback ISBN 9781760427535
What makes a good doctor? Medicine and Its Practice focuses on the lifelong clinical and personal skills at the core of the medical profession.
To provide good and safe patient care a doctor needs to be aware of their clinical knowledge and skills, be ethical and professional and manage their own self-care. How can doctors maintain good practice when faced with a situation that challenges these?
As well as meeting patient needs, doctors need to meet certain requirements of regulatory bodies. The Medical Board of Australia promotes self-reflection as a key part of good medical practice through its code of conduct.1 Whether motivated by internal or external imperatives, the ability to reflect on their practice is important in a doctor’s provision of good, safe patient care.
At the book’s outset, the author states that it is written ‘with all doctors in mind, to help them be aware of the pitfalls of clinical practice, to be more reflective and then to put measures in place to minimise the likelihood of errors and enhance the provision of ‘good’ care.’
Knowledge and theoretical texts about clinical skills abound, but practical books about the application of such knowledge and skills in practice are harder to find. This book is therefore welcome, as it draws together many of the challenges in practice and everyday life that all doctors will face at some stage. It will help doctors to reflect on their own personal practice and their approach to managing many of the challenging areas that arise in medical practice. The book also highlights the importance of looking after oneself when looking after patients.
Written by a general practitioner (GP) with extensive involvement in remediation through work for the Medical Board of Australia, The Royal Australian College of General Practitioners (RACGP) and in general practice training, the book reflects such experience in encountering and dealing with issues that arise in the practice of medicine.
Starting with a discussion about the nature of a doctor, the book explores the medicolegal and core clinical, ethical and professional areas of practice. In addition, there is a focus on self-care with chapters on wellbeing, resilience, mindfulness and the art of medicine. Case studies, guiding questions and suggested activities provide a practical context and promote reflection. For example, guiding the reader to move from the hypothetical of what to say in a challenging situation to the practicalities of what words they would actually use. Having case studies that are relatable and not all based in general practice ensures the book is relevant to all doctors and a resource for all areas of teaching. The book is also important as a reference for regulatory boards who ask that doctors regularly self-reflect as it will help doctors learn this important skill.
Where there is an obvious error or boundary crossing, reflection focuses more on why things went wrong. Fatigue, stress and ill health can affect us all at any stage of our careers and are a reminder of the importance of self-management to prevent errors of judgement. More difficult are the ‘grey’ areas to which many doctors can relate. They are not uncommon and can challenge doctors to bend the boundaries. The answers for dealing with such situations might not be straight forward so the points for discussion and prompting questions help the reader work through what to consider and how to manage such situations. For example, the section on treating family, friends and colleagues looks beyond the advice to just say ‘no’ and explores situations where even seemingly simple requests require reflection about the implications and how such requests might best be managed.
As well as focusing on the pitfalls, there is a focus on the importance of self-care with some thought-provoking chapters on applying mindfulness in practice and the art of medicine.
The book does not present a detailed discussion of all aspects of the cases presented and does not provide all the answers to every scenario presented. For example, how to communicate in a range of difficult situations refers to other work in this area while the medico-legal implications in some cases may depend on where a doctor works. For those who want more detail or guidance, there are suggestions for further reading at the end of each chapter.
Read through the book and consider the areas in your own practice that you are most concerned about, then use the reflective questions, alone, with others, or in your teaching. Self-reflection makes us all better doctors.