How self-reflection can aid in future success

29 May 2020 

What we can learn from Prince!

“G-E-N-I-U-S spells genius,” said Tom, my youngest son. Juggling spelling tests between Zoom meetings had started to become ridiculous, but it did remind me of my own school days, because then, the only genius I wanted to talk about was Prince!

To even an ardent fan like me, Prince went through a dark phase at the end of the 1990s when for 10 years he started to take himself a little too seriously. Thankfully he finally managed to “catch himself on” and started some amazing musical projects.

One of the most remarkable of these was in 2007 when he performed 21 concerts in the O2 Arena, London between August and September.

Amazingly, each concert was different, and he managed this by having a set of code words to signify to his band their next song choice from a list of 200 they had all prepared in advance. 

At the same time, Beverly Knight, a British Soul singer from Wolverhampton, was starting to make her way in the mainstream music scene. She had started her career singing in churches and cited her early heroes as Sam Cooke, Aretha Franklin and Prince.

She had always wanted to meet him, so imagine her delight when his management company phoned to invite her to be the warm-up act to several of the O2 Arena shows. 

She and her band worked hard and after her first concert she was shocked to be invited by one of Prince’s band members to come back to their hotel after the show. After ensuring it would be safe, she made her way to the top floor of the Ritz at 3am where, in Prince’s suite, the afterparty was in full swing.

One of the band members fixed her a drink and there in the middle of the room stood her hero wearing – guess what? 

Purple silk pyjamas!

He came over to her and quickly put her at ease by making light conversation and jokes. Taking her gently by the arm he then escorted her to a quiet corner of the suite where two chairs and a coffee table were placed.

Upon the table was a television and VCR. "Beverly, I enjoyed your show and I want to review it with you," he said. She was terrified – "I couldn’t possibly do that," she gasped, but he was persistent: "Relax – I review all my shows," he assured her.

He then proceeded to go through her performance of that night’s concert, pointing out the bits he thought went well and those which needed work.

True to his word, he then put on the recording of his own show and the band filled in behind their chairs and continued to critically appraise their own concert. “We sounded good at that bit, but the bass could have sounded stronger here,” and so on. 

It was a surreal experience and she left the hotel at 6am, through empty London streets, wondering what had just happened to her. It made a lasting impression though, and to this day she watches back all her own performances and continues to strive to improve as a singer and artist.

Self-reflection

The story to me killed the term 'genius'. I only see geniuses now as people with high innate talents who work extremely hard to perfect them. It also shows that if Prince can continuously improve his performances by self-reflection, then we all can!

Lucky people like Beverly get to meet their heroes. However, really fortunate people get to have them as their parents.

My own dad talked about studying for his MRCGP in 1974. We were away in County Mayo on a well-earned holiday and he recently talked to me about studying in the morning in the holiday house with his young children, including me at age one.

It is not easy juggling family commitments and exams so if you are studying for any part of your membership, we send you our support and look forward to celebrating your achievements in the near future.

Our advice to our ST3 colleagues sitting the Clinical Skills Assessment (CSA) is to get started with recording consultations as soon as possible.

The process of recording, polishing and reflecting on consultations can be time-consuming and we send all our specialty doctors a message of support here.

Videoing consultations is not easy to do, and I remember well my own experiences of selecting the best consultations, which showed specific areas I wanted to highlight.

I remember the biggest lesson I learnt when doing my consults was to stop talking and allow the patient’s voice to shine through.

Managing rare diseases in general practice

Self-reflection can be a very important and helpful tool.

I frequently take a moment after surgery and reflect on my own consultations and think about what went well and what I could have done differently.

Shortly after commencing my partnership in Kilkeel, a new patient called David joined our list who had recently been diagnosed with Kennedy’s disease.

Kennedy’s disease is a rare X-linked variant of motor neurone disease and he suffered from the condition for 10 years before his death. It was very difficult watching his proximal neuropathy develop, literally from the ground up.

When he started attending our surgery, he was able to walk and drive himself. This diminished gradually and progressed to the use of a stick, rollator, manual wheelchair and ultimately motorised chair.

The disease did not stop at waist level though, and necessitated continuous positive airway pressure (CPAP) and feeding tubes, distorting his voice and ability to swallow.

When I first met David, I had to confess I didn’t know much about Kennedy’s disease and for the first six months I genuinely felt he and I were in a learning phase together.

His disease inevitably required input from a variety of specialisms like occupation therapy, physiotherapy and neurology.

I was struck by the importance of having a generalist at the centre of his care – based in his community and able to co-ordinate the various teams at the stages when he needed them.

Rare diseases can be intimidating to manage as a GP, and there is an excellent article in May’s edition of the British Journal of General Practice on how to manage rare diseases in practice. The links to the websites are great and I wish I had access to the likes of Orphanet then.

It is an interesting site to browse and I like its opening gambit:

"Rare diseases are rare, but rare disease patients are numerous."

The article was written by a number of Northern Ireland doctors, including Professor Margaret Cupples, so it is fantastic to see an NI paper in our academic journal under an NI editor.

We are urging the Department of Health to invest in academic pathways in general practice.

The current crisis has highlighted the need for our workforce to have highly trained GPs who are skilled in research techniques so we can be adequately represented in UK and global research projects as well as analysing important data from our flu surveillance practices.

I will feedback how we get on with this work and it will be great to see more published work by GPs in Northern Ireland.

Self-reflection is not just about what we do ourselves in our surgeries but our wider role within the whole of health and social care.

I have reached out to GPs throughout this pandemic – I have been answering email queries, telephone calls and hosting Zoom meetings, including a session with almost 40 colleagues earlier this month on how general practice might look post COVID-19.

Change is coming - let us hear your voice

Despite this, I am still very keen to hear your feedback and how we can best represent your views, so please get in touch
 
Before we entered this new COVID-19 world our waiting lists were among the highest in Europe.

While this may not be our fault, they are our problem and affect the lives of our patients. Long waits for secondary care services inevitably create extra work for our practices through repeated reviews, complications of untreated conditions and the need to request additional tests.

We must play our part in making our health service better. I don’t have all the answers to these questions, but I want to hear your views and opinions. It is vital your voice is heard.

Email: ChairNI@rcgp.org.uk
Twitter: @laurence903


Post written by

Dr Laurence Dorman, Chair of RCGP Northern Ireland

Dr Laurence Dorman took office in November 2019 after three years as Deputy Chair of Policy for RCGPNI. A GP principal in Mourne Family Surgery, Kilkeel, Co Down, since 2007, he is the fourth generation of GPs in his family. He was also, until recently, the Chair of Newry and District GP Federation. 

Laurence has particular interests in new ways of working in primary care, cancer care, and inspiring the next generation of GPs. He set up the successful 'Dear Colleague' initiative to improve the interface between primary and secondary care and has been a strategic advocate for interface and communication since September 2017.

During his time as Chair, he wants to support College members to ensure that the future of GP services is protected, supported and sustainable.

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