The invisible GP

[摘要] A patient recently asked me when the practice was going to open again. I replied that I was, at that very moment, seeing them face-to-face in my consultation room. ‘I know,’ they replied, ‘but you know what I mean.’In our media-infatuated world, the mere image of a general practice appearing closed holds more significance than whether it is truly open.1 The power of images in shaping public perceptions of health care is not a new phenomenon. In the UK, GPs in particular have inherited cultural legacies ranging from Fildes’ The Doctor through to Berger’s A Fortunate Man.2,3 However, the influence of our curated history is challenged by the number of images available today. In 2021, users of Facebook are estimated to have shared 240 000 photographs every minute.4 With a deluge of data, there is an incentive for users to selectively share items that attract attention rather than accurately conveying everyday realities. Medical imagery, when shared in such contexts, is often centred either on narrow spectrum, hard to access or high-cost interventions. Although these services are critical to the health needs of a select few patients, the saturation of modern medical imagery with technocratic motifs is a problem for healthcare systems where holistic generalists have a gatekeeper function. Such images provide wider society with repeated glimpses through the keyhole where the wizard works magic.5IMPOSSIBLE HEROES When patients are unknowingly enveloped by illusions, it is unsurprising that rare exceptions of care become routine expectations of care. Images are therefore more than what they simply record, they create a narrative. The emergence of global pandemic could have been an opportunistic juncture for the limits of atomistic medicine to be laid bare while showcasing a healthcare system operating in synergy. Instead, COVID-19 accelerated the trend of healthcare imagery to focus almost exclusively on hospital environments. At the time of writing, an internet image search for a ‘covid doctor’ did not yield an obvious photograph of a GP. Conspicuously absent from this modern exhibition, we are perceived as lazy, in hiding, or even irrelevant despite having a major role in the pandemic response. The experiences of GPs throughout this period are testimony enough but the injustice of this algorithmic verdict is inflamed by the knowledge that GPs have had the highest risk for COVID-19 deaths among doctors.

[学科分类] 卫生学