Conditions such as certain viral infections, mild to moderate psychological distress, and common musculoskeletal issues usually resolve on their own, yet they are still among the most frequent reasons for visiting a primary care clinician.
Typically, we will use narrative diagnosis and reassurance, pharmacological treatments, such as medicines or minor surgery, and referrals to tackle any issue that walks through the door.
As an early-career GP, I encounter scenarios requiring effective patient reassurance while also providing the necessary safety net advice.
We do a communication dance with patients, trying to achieve this delicate balance. However, this can be quite challenging when you are a new primary care clinician. On one hand, clinicians aim to reassure patients about the self-limiting nature of their ailments. On the other hand, they must provide safety net advice to cover potential medicolegal concerns, which, in my view, can inadvertently undermine the reassurance given.
Here are three tips that can improve consultations when discussing conditions that typically resolve without intervention:
• Being well-informed enables you to confidently reassure patients. More patient contact will facilitate your familiarity with conditions like viral infections and pain syndromes, which often resolve on their own.
• Building trust with patients over time can enhance their confidence in your advice, which may mitigate unnecessary follow-up visits for the same symptoms. It helps if you are working long-term with a fixed population.
• Look for ways to refine your communication techniques. Ensure that your reassurance is not overshadowed by safety net advice. For example, instead of focusing solely on the potential for symptoms to worsen, balance your advice by emphasising the benign nature of the current condition.
It’s common practice for clinicians to advise patients to contact 111 or 999 if symptoms worsen. However, this can inadvertently transfer some of the clinician’s uncertainty or medicolegal anxiety to the patient. Instead, consider framing your advice in a way that empowers patients. For instance, you might say, “This seems like a benign condition. Remember, we are here every day, so if you develop additional symptoms, don’t hesitate to call us back.”
Experienced GPs find that patients rarely return for the same symptoms when safety netting is communicated in a patient-oriented manner. This approach not only reassures patients but also empowers them with the knowledge they can share with family and the wider community. Ultimately, this cultivates a more informed population, better equipped to understand which conditions will likely resolve on their own.
In essence, the goal is to create a healthcare environment where patients feel both reassured and informed, understanding that many common ailments will improve without further intervention. As clinicians, we can enhance patient trust in self-management and collective health awareness.
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