Mulching a garden is a lot like consulting with patients. Both activities require time, dedication, and manual work that can leave one physically and mentally sweating. While neither are normally not noticed, the return on investment is well worth it!
Mulch forms a superficial, protective layer that buffers against extreme temperature fluctuations, ensures efficient use of water, helps to control weeds and pests, prevents erosion and some types of mulch supply nutrients.
Like mulch, the specialty of general practice confers much more value than may be apparent to a casual eye. General practice provides continuity of care, a patient-centred and holistic approach and the flexibility to simultaneously assess undifferentiated presentations, manage chronic conditions and offer screening and health promotion. Consultations synergistically combine with the potential to create a metaphorical protective layer for patients.
There is ample evidence that effective therapeutic relationships between clinicians, consumers and carers enhance outcomes and is a generative mechanism of metaphorical protective layers. As we grapple with the challenges of the modern epidemic of loneliness, the relational dimension of consultations will only increase in importance.
The influential Harvard Study of Adult Development provides fascinating insights about the key determinants of human success, happiness, and longevity. By analyzing rich data collected over an incredible 79 years, researchers identified a common and recurring theme – the quality of our relationships is the single most important determinant of our wellness.
A subsequent study with more than 300,000 participants found that the lack of strong relationships increased the risk of premature death from all causes by 50% – an effect comparable to smoking 15 cigarettes a day, and a greater effect on mortality than obesity and physical inactivity.
Primary care clinicians and staff appreciate the value of relationships. We understand that social connections are literally a matter of life and death. Unfortunately, policy makers and funders often take this aspect of care for granted and fail to understand the time, skill, and investment it requires.
Like mulch, the specialty of general practice produces value in a way that seem almost magical. However, it requires recognition and support to be a sustainable act.