finAl tHouGHt…
final thought…
Dr Euan Lawson, a portfolio locum
gp from Kendal, steps out of the
surgery and into the wild to explore
the peculiarities of locum craft
M
o
.
c
t
o
o
i
like there is no doubt that a
H
p
the

to think of locums as
ray Mears of the gp little resourcefulness goes
K
c
world. all gps will use a a long way. Many gps
t
o
s
wide variety of skills each wonder how locums can
a
t
/
i
a
Y
day, but locums need to be manage patients without
resourceful and determined detailed prior knowledge of
e
l
i
H
d
to survive and thrive in the their old problems. i won’t
primary care jungle. never dispute the clear advantages often try to throw in a little to eligible daughters.
trust a rich gp or a thin of continuity of care, but i “it’s a rum do” grimace to so ray may suggest
survivalist and ray is a think the answer lies in a emphasise my solidarity. that “knowledge doesn’t
well-fed fellow who looks little used arcane technique in locum craft there are weigh anything” but
like he has mastered his art. deployed by locums subtle warning signs of he has obviously never
Wholly attuned to a hostile known as... history taking. impending danger that considered the ultimate
yet beautiful environment, as essential as an antler- should be studied and survival resource for locums
ray declares that bush craft handled knife to ray, your learned. some of these – the senior receptionist. i
is “the art of the possible”; a history-taking skills should will be familiar to all gps: would guess that neither
useful approach for doctors be honed to perfection if patients with lists, or anybody has he tried carrying the
developing their own locum you want to achieve mastery on diazepam who attends complete collection of
craft in the modern nHs. of the art of locum craft. a late on a friday afternoon. oxford Handbooks around
You have to be prepared locum examining a patient occasionally, the storm every practice in the county.
to rough it a little as a locum. should be reminiscent of will strike a locum without there’s still room in my bag
there are some practices a tracker stooped over warning. this week a patient for a gadget or two and
where i’ve worked in every fresh rhino spoor, but came into my room with although a satnav may be
single room in the building and personally i recommend the not uncommon opening a touch more Bear grylls
i’ve been shunted around like drawing the line at stool gambit of “but you’re not my than Mears, i would wager
an ugly, unloved occasional inspection in the surgery. usual gp” and i feared the that ray has never had to
table. i once ran a clinic in a it is worth bearing in mind worst. i sat quietly and tried juggle an eMis printout and a
toilet block in Bosnia and that with locum craft that there manfully to exude empathy dog-eared map as he toured
was more salubrious than are many predators and the as i passed the tissues. Her the local council estate in a
some of the consulting rooms natives need to be handled face crumpled and after a downpour on a late visit.
to which i’ve been banished. with care. i’ve been winched minute or two of repressed ultimately, any gp can turn
locums have to be hardened into a Borneo jungle, but it sobs she got up and left. i felt up and see a waiting room
to the often disturbing insight wasn’t as unnerving as being like i had just been caught full of patients, but there is a
into the psyche of the gp metaphorically parachuted out in the open in a sudden crucial ecological niche for
on whose territory they are into a failing practice. the and unexpected deluge. i savvy locums in the general
squatting. foraging is a receptionists lurched around paused and reflected for a practice wilderness. there
key skill in locum craft and like hungry bears rudely moment. What would ray will be scant appreciation
the ability to track down a woken from hibernation and do? What is needed is an on the patient satisfaction
microbiology form in teetering the patients were practically early warning system and surveys to show for your
tower of Qof paperwork baying at the door. even all practices have them. locum craft, but it is possible
is not something that can in good practices patients in fact, they usually have to do much more than just
be learned in a clinical skills seem to be worryingly several and the simple act survive the experience. and
lab. the top drawer of a prepared to badmouth their of treating them like human as ray almost said: “the
gp’s desk is a source of own gp to a locum. My beings will be enough to great thing about locum
rich pickings for essential preferred technique is to activate the defence. Making craft is that wherever you
forms and usually reveals the nod empathetically while tea for reception staff can go, the skills go with you”.
obligatory packet of tramadol simultaneously wobbling even result in adoption Dr Lawson is a portfolio
amongst the yellowing vintage and tilting my head in a as the unofficial practice GP working in Cumbria
sick notes from the 1980s. non-committal fashion. i mascot or introductions and North Lancashire.
30 sessional gp | voluMe 1 | 2009 www.mps.org.uk
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