Slow Medicine

I recently began working in a new Mackay medical practice started by Dr Nicole Higgins called Health on Central.  And when I say new I mean new. Last time I visited the building it was to buy some screws as it had previously been a hardware shop. Sadly, competition from the mega hardware supermarkets down the road meant the the business became unsustainable and it closed down. Turning a gutted hardware store into a multioffice medical clinic was an adventure I’m sure she will tell you.

The clinic still has an industrial look about it, big windows bring in natural light, a living plant wall, a bench from an old train station and dining table in the middle of the waiting room.

Because the clinic is new, I get to spend 30 minutes with patients and this really has opened my eyes to a different way of practicing medicine. I felt I had time to listen to patients story. Studies have shown that a patient is interrupted at between 12 and 23 seconds after starting their story. Obviously this interruption may mean vital information may be lost and it can make the consultation longer. The silence of the doctor is a neglected tool in building rapport. They are many papers which focus on improving doctor -patient communication. Dr David Dugdale wrote Time and the Patient–Physician Relationship in 1999 which is a good starting point for those seeking to improve the efficiency of time spent in consultation. Dr Simon Morgan, who tried to teach me General Practice up in the NT, wrote this a paper on consultation skill tips for new GP registrars.

Dr Nicole recently exclaimed “Slow Medicine” in a GPDU post, and I thought that sounds like a really good idea. I have a slow cooker at home and I can use it to make wonderfully richly flavoured food. As I discovered Slow Medicine is not a new concept. Dr Alberto Dolaro an Italian cardiologist, wrote about in 2002. It is said he was inspired by the rising Slow Food movement, a reaction to Macdonalds in the culinary heart of Italy. His paper’s abstract describes his ideas,

In clinical practice, hyperactivity is often unnecessary. Adopting a strategy of “slow medicine” may be more rewarding in many situations. Such an approach would allow health professionals and particularly doctors and nurses, to have a sufficiently long time to evaluate the personal, familial and social problems of patients extensively, to reduce anxiety whilst waiting for non urgent diagnostic and therapeutic procedures, to evaluate new methods and technologies carefully, to prevent premature dismissals from hospital and finally to offer an adequate emotional support to the terminal patients and their families.

This goes beyond the drive to improve efficiency in the consultation. The movement focusing less on the time but more on the relationship between doctor and patient, the connections made and our shared humanity. The Slow Medicine has been aligned with the Choosing Wisely movement which aims to educate both doctors and patients that quality of healthcare can be achieved by eliminating unnecessary and sometimes harmful tests, treatments, and procedures. Yes less tests can be better for you.

If you are interested in reading more opinions and thoughts on Slow Medicine here are a few links.

Direct to the source but you will have to rely on google translator if you don’t speak Italian. Slow Medicine Society.

I love the snail logo and their Manifesto which is available in English.

Sobria, Rispettossa, Giusta

Measured, Respectful, Equitable

And if you speak Portuguese have a look at the Brazilian version of Slow Medicine.

If Slow Is Good For Food, Why Not Medicine?

I’m so glad I don’t work in an eight minute medicine world!

For the Very Old, a Dose of ‘Slow Medicine’

I think it is not just important for older patients, I think all ages will benefit.

This paper discussed the pressures those who practice Slow medicine may face.

Dr Michael Finklestein is a strong proponent for slow medicine you can read his thought on his website and his Huffingtonpost articles.

As he says

“In our fast-paced world, we often look for quick-fix solutions to our health challenges, not realizing that these “solutions” in fact may contribute to our problems. Most health challenges are the result of an imbalance in our bodies and lives, and most quick-fix solutions actually exacerbate these imbalances. If, instead, we take a Slow Medicine approach – identifying the root cause of our health challenges, then creating a thoughtful, step-by-step, and long-term response to it – we effectively bring ourselves back into balance.”

If you are interested in benefiting from Slow Medicine, the next time you book an appointment with your doctor, ask how long you get for a standard appointment, and if you think you deserve more than 8, 12 or 15 minutes, ask for a double or even a triple slot, it may make for a less time-stressed appointment.

And, finally I’m sorry if I am running late one day, someone maybe needing my slow care!