Managing relationships with your medical team
With the very well recognised increasing pressure upon and within the NHS, it is becoming more necessary to teach mechanisms of self-reliance, not as an alternative but as a foundation to which any medical interventions can be added. The longer term benefits of such an individualised approach are very widely accepted. A major consideration is the time and resource limitations that influence decision-making; misunderstandings can arise and if uncorrected can lead to negative consequences for your health. Unfortunately the Doctors confounding concerns of medicolegal responsibilities can be a distraction from the primary objective of health gain. Often such considerations hijack the agenda and once a life-threatening condition is excluded, you find yourself no further forward. The Doctors legitimate concerns can also lead to an excessive medicalisation of an issue. Getting the interaction right to maximise mutual understanding takes great strength at a time when you may not be at your best. The Doctor spends their working life managing their interactions with patients; how does the patient learn to interact with the Doctor?
Confidentiality
The health consultant abides by the very highest standards of confidentiality. GMC guidance states:
"However, there can also be a public interest in disclosing information: to protect individuals or society from risks of serious harm, such as serious communicable diseases or serious crime; or to enable medical research, education or other secondary uses of information that will benefit society over time."
This is a great compromise for the health consultant as it inhibits open discussion, which could certainly be against public interest. This obligation is not new, but the pressure to abide by it continues to increase. This is quite right, proper and serves society well enough. However, the fear of standing accused of incompetence can result in professionals following a bureacratic process that results in great harm and misses opportunities for more appropriate local management. It is also the case that open trusting dialogue is prevented, removing the possibility for negotiating law-abiding behaviour. Society also benefits from access to support for individuals, offered in confidence and this is the ideal of a health consultant. The behaviour is condemned and not the person. In fact an attempt is made to rescue that person, by guiding them towards engagement with an appropriate authority for the good of society.
For this reason it would be preferable if a health consultant is not registered with the GMC so as to be free of the obligations and open to a more individually responsive approach to a problem. If a health consultant is registered with the GMC they should declare this explicitly to their clients at the outset.
Records
By the nature of the work a health consultant does, health records can be kept without any personally-identifiable data. The health consultant suggests only communicating practical information such as appointment arrangements via e-mail and not sending personal health information in written form. There is no information for prospective employers, regulatory authorities, insurance companies or any other third parties to have access to.
