Aust Fam Physician
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Like the featured authors, we have spent most of our working lives in remote, mostly Aboriginal communities. A common theme in these papers is the need to link clinical practice, prevention and appropriate policy to improve health outcomes. We need to consider our patients and their wider social context.
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I recently participated in a registrar education discussion about 'heartsink' patients. What is a heartsink patient? O'Dowd appears to have coined the phrase and refers to patients who 'exasperate, defeat and overwhelm their doctors by their behaviour'. He implemented a plan to identify, discuss and actively manage the heartsink patients at his practice and his definition has led to a classification of typical trigger patients and guidelines on how to best manage these patients
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An invitation to discuss the role of the doctor begs the question, 'What is wrong with the status quo?' Given the guild nature of the medical profession, any reform will need to be well substantiated.