1. What makes a good doctor 10 Guiding Rules Professor John Murtagh AM MD

2. What makes a good doctor “The doctor should have a kind disposition, great patience, meticulous freedom from prejudice, an understanding of human nature resulting from an abundant knowledge of the world, adroitness in conversation and a special love of his calling” G Greisinger 1840 Big 3 attributes- caring, responsibility, knowledge

3. 1.Develop rapport & good communication skills Big 2: listening best name Others: friendly greeting respect and courtesy well briefed non-judgemental

4. 2. Ask the right questions Why have you come to see me today? Do you have any particular concerns about your health? Tell me about things at home? Tell me about things at work? What do you think deep down is the cause of your problem? Is there anything that I haven’t asked you and that it would be best if you told me? Is there anything in your life that you would like to change?

5. Optimising questions

6. 3. Be astute and observant The art of physiognomy (Addison)-- the art of reading both physical and emotional problems from the face and body language “ Watson you see everything but observe nothing” Sherlock Holmes Osler re observation

7. 4. Develop optimal ethical & professional standards Hippocratic oath The Declaration of Geneva ---------------------- Virtues Cardinal- prudence, justice courage,temperance Key- generosity - compassion - tolerance - gentleness - politeness - humour

8. The wisdom of Hippocrates First do no harm Wherever the art of medicine is loved, there is a love of humanity Cure sometimes, treat often, comfort always

9. 5. Foster Clinical reasoning and critical thinking Objective- outstanding diagnostic acumen Main methods – David Sackett # Complete traditional model # Pattern recognition # Hypothetico-deductive model # Multiple branching-stepwise algorithms

10. 5c. Have a fail-safe diagnostic strategy What is the probable diagnosis? What must not be missed? What are the pitfalls? Have I learned from past mistakes? Check the common masquerades Is the patient trying to tell me something? Hidden agenda/ ticket of entry What tests should I order?

11. 6.Develop your own guidelines For diagnosis and management of common symptoms e.g. headache, back pain, acute chest pain, rash, acute abdominal pain, breast lumps sick febrile child common conditions eg angina, diabetes, hypertension,cardiac failure,asthma, epilepsy

12. 7.Know essential therapeutics Know your key drugs by heart and the prescribing issues Keep up to date Avoid using drugs if there is an alternative- consider complementary strategies Be good at treating ‘nitty gritty’ problems eg dandruff, halitosis,cramps, warts, tinea, eczema, stress, mouth ulcers, anxiety, lumbago, pruritus ani and vulvae Promote patient education handouts extensively

13. 8. Develop basic procedural skills Advantages continuing skills improvement more interesting and satisfying work cost effective for your patients

14. 9. Be prepared for emergencies Managing emergency conditions is a huge but interesting and rewarding responsibility Be prepared-plan, equip, practice eg CPR

15. 10.Develop supportive networks Know your consultants/hospitals Colleagues Communication Social workers phone Religious/counsellors phone Allied health team phone CAT team phone Psychiatric services Internet