Feeling a little sad today, seeing patients. There is a perceptible distance between us now that I am just a part time locum, not their full-time GP. Seeing one old boy that I have known for 20 years made me realise just how much my personal knowledge contributes to the diagnosis as well as to the quality of the relationship.
With the sadness comes that old feeling of resentment against the bureacracy who have destroyed the quality of the doctor patient relationship with their endless quantifications (ironically, all under the heading of the QOF - Quality and Outcomes Framework), and against Government, who want to destroy small practices where the patients can see a doctor who knows them, and drive us all into huge multi-doctor MDTs (Multi Disciplinary Teams) where nobody knows anyone.
In a meeting I once asked what Outcomes meant. Nobody knew.