Being a GP Supervisor... Extra demands and staying sane...

Uncategorized Aug 24, 2018

One of the other GP supervisors has been away for two days, so I've been looking after two registrars.

It is a interesting experience - just in taking all of the phones calls, and fully experiencing the demands that are placed on GP supervisors.

It's definitely an extra level of skill set that's required compared to not being a GP supervisor.

I think one of the big challenges is the interruptions.

Leaving the case where I'm dealing with my patient, then going and sorting out the other patient that the registrar's working with...

How do I help them sort out their patient?

How do I help the registrar to learn?

How do I make sure that they're safe, make sure that we're not missing anything?

Then coming back and then hopping back into my patient and helping them.

It's quite a demanding experience, and the hope is that despite this I can still go home confident that I've done my work for all my patients, as well as provided a growth experience for the registrar.

So how am I doing it?

Presumably, if you're a GP supervisor, you're familiar with this challenge that we face.

Here's a couple of things that I find helpful.

Number one, knowing how I think can help get me through when I have to jump into a registrar case.

Also, teaching them.

"Hey, how are you thinking? How are you dealing with your clinical reasoning?"

I use the Dynamic Assessment Structured Management model for thinking through what's going on...

If you're not familiar with this, it's basically what the patient's story is plus their background, plus what I know of them.

Then working through differentials. What could be going on for the patient?

Then asking from the history, exam and  investigations to work out and refine down to either "Yep, I know what's going on" or "I've reduced down to a smaller amount of differentials."

Then of course also making sure the don't miss diagnoses and serious stuff, that I want to make sure my patient doesn't have, are also dealt with.

I call that Dynamic Assessment.

I also need to rapidly access critical information.

I use a tool called a Key Feature Checklist, which I developed in the requirement to develop new key feature problems for the RACGP exams.

I found it very difficult to hold large amounts of information about multiple diseases at once and so what I realized is, "Hey, what would make a massive difference is if I actually had a functional subset of information about these diseases."

Just the Key Features and not the 52 page in depth journal article level of information.

I find them extremely helpful.

They're the two major tools that I use, Dynamic Assessment Structured Management and Key Feature Checklists

The model for how to think in general practice.

Also the capacity to rapidly access critical information about diseases for what's going on.

Look, I hope you're all having a awesome day.

I'm really grateful for all of the GPs out there doing supervisor work and for the GP registrars coming through.

We really do provide a wonderful service for our patients and also in training the next generation of doctors.

Thank you for joining me in this discussion and I look forward to seeing you again on future GraduateMedicine trainings.


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