A PERMANENT HOME FOR SINGLE HANDED GP'S

By The College
Contact the author by e-mail at christopher.johnstone@ntlworld.com

RCGP Scotland now hosts the single handed exhibition of GPs in remote and rural Scotland. The exhibition conceived by Professor John Bain of the University of Dundee and carried out by Rosie Donovan is a series of photographs and consultations with GPs working in isolated communities in Scotland. It is hoped that members will take pleasure in the 47 photographs located on the staircase of 25 Queen Street.

From the first showing in London Ontario in 1999 the collection has travelled widely to various events, from Orkney and Shetland in the north, extensively throughout Scotland and as far South as Spain for the Wonca conference this year.

This project focuses on single handed doctors, a unique band who serve small and isolated communities throughout both the Highlands and Islands and other remote areas in Scotland. If there is anything true of small rural medical practices, it is that no two are alike. Practice in a rural area is unique in that the doctors are not just working in the community, but are very much part of that community. To work in a rural community means that private and working lives are inextricably linked. Patients are well informed about the details of the doctors' lives, recreation, families and a host of personal matters. The doctors often know more about the patients than the formal medical notes would indicate. However, it is being part of the community that makes single handed practice a unique experience. The exhibition sets out to capture this unique relationship.

Doctors who choose to be single handed are self selected, each one of them finding the places and jobs that suit their personalities and they are moulded by the situation in which they find themselves. Boundaries between doctor, patient, friend and acquaintance are always blurred in these small practices. This visibility can be difficult to manage and those coming from an urban environment may take some time to adapt, and to develop the social skills required in a remote sparsely populated rural environment.

In this project, forty-seven of the two hundred-odd single handed doctors in Scotland report on their experiences and provide an insight into their unique contributions to rural Scottish health care. In 1998, Rosie Donovan spent six months travelling by Land Rover, from the Rhinns of Galloway in the far southwest, to Unst, the most northerly of the Shetland Isles. She visited doctors working under a wide range of conditions: from small island communities, separated from the nearest hospital by a ferry journey of several hours; to practices which, while only ten miles apart, are separated by a mountain road often impassable in winter.

She recorded interviews with doctors, in which they discussed life as the sole physician in a remote community, their views on their responsibilities to their patients as well as to their own families, their feelings about this form of medical practice and their hopes for its future. Each chose a favourite location for a photograph which they felt best represented their place of work. There were times when the doctors' busy schedules allowed her little time to get to know them, interview them, record their impressions and experiences of life as a rural doctor, and find a suitable location for a portrait. Sometimes the demands of their practice meant that they could spare as little as half an hour.

At other times, she could spend longer getting to know them, and often, after the work was done, go sailing or hiking in the hills, have lunch or dinner, and meet their families. For her, it was a tremendously rewarding experience, as she gained insight into the lives of these dedicated physicians and made friends for life of many of them. The accompanying texts illustrate their commitment to single handed practice as the art of medicine.

hoolet is the magazine of RCGP Scotland. It is supported intellectually, financially and emotionally by RCGP Scotland.

This issue maintained by Robert Hallam.