Thoughts and opinion from the wards
Wonderful Wonca in Vienna
Wonderful Wonca in Vienna
I had been looking forward to going to the WONCA conference in Vienna since the start of the year. It promised to be an exciting mix of holiday – cafes and music in Vienna, cycling by the Danube, and historical sites, with a really interesting conference about general practice, and learning about the challenges of family medicine in many different countries. I was therefore not expecting that while the opening ceremony was going on, I was speeding in an Ambulance to a hospital the other side of Vienna to taste the actuality of Austrian Healthcare. Unfortunately I had taken the holiday part a bit too literally and after registration had cycled quite a way on the path beside the mighty Danube. It was very hot (and sunny) and at one point I lost my balance and fell, gashing my leg. Blood went everywhere and I realised I had sliced a bit of flesh almost through. It was going to need stitching. So after putting a tight handkerchief round it, I wondered what to do next. Well, there were about 2,000 GPs available not so far away so I made my way (with husband) back to the Austria Centre where the conference was being held. There it took a bit of time for the reception desk to understand that I actually needed a doctor, but eventually they contacted the doctor on call. He came straightaway to see me in a little clinic room on site.
He was actually the organizer and chair of the DOCSART exhibition. The theme of the conference was Art and Science in General Practice, and aimed to explore the difficulties in balancing the art (intuition, compassion and patient centred ness) with the science side (evidence based medicine, guidelines and the bureaucracy that modern medicine entailed). So, as part of the conference he had organised and collected art done by family doctors from all over the world, and was at that moment hanging many of them himself. There was also to be a performance of the European doctors orchestra at the opening ceremony and a local string quartet was to play during the meal. So it can’t have been what he most wanted when he was asked to see to someone’s cut leg. But he was kindness personified, and after cleaning the wound and informing me what I knew already, that it would have to be stitched, he arranged an ambulance and wrote a letter in the time honored fashion to the emergency hospital.
The ambulance took me right to the other side of Vienna, passing three hospitals on the way, which could have seen me. However they had a neat computer programme which told them what was the likely wait at each hospital, and so when I arrived at the recommended hospital 50 minutes later, I was seen straightaway. I was neatly stitched in a small theatre by a doctor who was also a Chess Grandmaster, assisted by another doctor who was a table tennis aficionado. They all spoke perfect English. They sorted out my EHIC insurance (which appeared to have expired) and generally the whole thing was pretty impressive. I got back at the end of the opening ceremony in time to join my Norwegian friends who had invited me, at the welcome reception and have a lovely meal with them.
The next two days were an intensely mind expanding experience. My take home points were –Iona Heath’ s talk on the art of doing nothing – that is the art of noticing, listening thinking waiting witnessing and preventing harm, when as is so often the case nothing needs to be done. She told us that evidence showed that patient satisfaction is correlated with increased mortality – a dreadful inditement of what we do unnecessarily as docotrs. Then the concept of shared decision making as a counterpoise to both Evidence based medicine and Patient centred medicine (and patient choice) both of which on their own can be very restricting, was something that resonated very well, having been to conferences where both have been extolled as the only way to look at medicine.
Then Claire Gerrada on the Wonca World Café - a call to action for family medicine in Europe to make sure that family medicine is properly resourced, when it is known that without primary care health systems are fragmented, expensive and ineffective at getting health care to everyone. This was well attended with a really good discussion.
A talk on breast cancer screening and how to advise patients in these days when it seems it can do more harm than good. I at any rate decided I will no longer take up my invitations to breast screening.
There was a talk on treating dizziness in general practice with a booklet for rehabilitation, which promises to be very useful, and a talk on the negative findings on exercise for depression, which has been headlined in so many papers and publications.
Finally I joined my Norwegian host in his workshop on referrals from GPs to specialists, to give my presentation, ad take part in the discussion with GPs from Korea, Japan, Australia Ireland the Netherlands Austria Norway and Germany.
I have been to many conferences before but this one was superb. To see so many young doctors so enthusiastic about their speciality of family medicine and determined to improve it was a very positive experience. I recommend it to any jaded GP.