As author Polly Morland was cleaning her mother's library she came across a misplaced book. It was, "A Fortunate Man" (1967) by John Berger, which was about a country doctor who practiced in her own community some five decades before. The book is about the doctor who replaced the Fortunate Man, who herself was inspired to pursue family medicine by the same book when she was a medical student two decades earlier. Even before the pandemic, doctor-patient relationships were in serious trouble. A mobile population, a shortage of doctors, overwhelming workloads, the move towards part-time working (for many GPs, the only way to endure the pressures of the job), bigger practices, larger teams: all of this gnawed away at the humanity of primary care. Meanwhile, the rise of evidence-based medicine has seen a shift towards the management of health risk via a playbook of standardised interventions. While this has driven progress in the treatment of many illnesses, it’s had unintended consequences for the relationship between GPs and their patients. Precisely because the value of those relationships is difficult to render in cold, hard figures, performance metrics are skewed towards outcomes that are easier to quantify. The emphasis, and indeed the measure of success, has shifted from the individual patient to the disease. This book was fabulous - its about the doctors commitment to understanding her patients and building long term relationships and how this is the foundation of her practice. It oozes of respect and humility, of humanity and hope. Log in to your NB Dashboard and use the 'Add Reflective Note' button at the bottom of a blog entry to add your note. A Fortunate Woman tells her compelling, true story, and how the tale of the old doctor has threaded through her own life in magical ways. Working within a community she loves, she is a rarity in contemporary medicine: a modern doctor who knows her patients inside out, the lives of this ancient, wild place entwined with her own.

A Fortunate Woman by Polly Morland - Pan Macmillan

The descriptions of both the people and the place are a delight, beautifully illustrated by Richard Baker’s photographs. Although there is loss and grief in this book, it is also a celebration of what general practice can be at its best. Recommended reading for all aspiring doctors, and especially for those working in health policy, so they may understand and preserve the crown jewels of the NHS. Dr Helen Salisbury, Nuffield Department of Primary Care, University of Oxford Insightful, moving … instructive when so many practices are in crisis. A Times Audiobook of the Year 2022In May, the Commons Health and Social Care Committee held an evidence session on continuity of care. They heard from Dr Jacob Lee about what it’s like to see someone in a practice that doesn’t have personal lists. “You are trying to read their notes and get a feeling for what has been happening in the past. It makes the consultation really challenging when you are looking at blood test results and letters for patients you do not know because they are split between the different GPs who are in that day. It is so inefficient and difficult to try to do a good job for that individual.” I loved this book. It has, at its core an examination of what used to be called a "family doctor" embracing the element of continuity of care. Sadly, although modern general practice (and many patients) aspires to cling to this principle, it has been eroded year on year by both the pace of life and the number of doctors per capita. Most of us over the age of 30 can remember the family doctor we had when we were kids. They met us as babies and watched us grow up. They knew our stories, those of our siblings, our parents and often our grandparents, too. These stories were fundamental to the bond of trust between doctors and their patients. We are now learning that this deep, accumulated knowledge was also palpably beneficial in medical terms. It’s worth reading A Fortunate Man as half of a diptych, followed by this new book, A Fortunate Woman, immediately afterwards. The latter came about through a perfect alignment of coincidences. The author, Polly Morland, is a journalist and film-maker with a kindly, dramatic writing style and a feel for the human story. In 2020 she was clearing her mother’s house, after her mother, suffering from Alzheimer’s, had been moved into a care home. It followed, she writes, a “frightening and chaotic” year of “doctors and paramedics, nurses and social workers”. They had all been “well meaning and professional”, but none had known her mother “before all this started, nor stayed long enough to get to know her now”.

A Fortunate Woman: A Country Doctor’s Story Kindle Edition A Fortunate Woman: A Country Doctor’s Story Kindle Edition

I know this not because I am a doctor myself, but because I’ve spent the last two years studying one. Over many months, I observed a remarkable female GP at work in the same rural practice portrayed in A Fortunate Man, John Berger’s classic account of a country GP in the mid 1960s. In the course of around 130,000 patient encounters over more than 20 years, she has built something that many doctors no longer enjoy: high-quality, longstanding relationships with her patients. As A Fortunate Woman ends, ‘after the longest of winters, comes spring’ and with her patients vaccinated, a return to face-to-face consulting, new staff and a trainee our Fortunate Woman is beginning to feel hopeful again: ‘She crouches down next to her bike to peer into a hole in the wall where a stone came loose a few weeks ago. Inside, there is now a nest. New life, she thinks.’Beautiful and fascinating … it combines the structural elements of storytelling with the skill of real-life reporting, clustering them in the brilliance of a cloisonné-finish. Dundee University Review of the Arts Contains a profound message for the future at a critical moment for general practice and us all' - Wendy Moore, TLS

A Fortunate Woman: A Country Doctor’s Story - The Top Ten A Fortunate Woman: A Country Doctor’s Story - The Top Ten

Christina Patterson, Sunday Times The doctor's kindly, hollistic approach - she makes time to investigate her patients' social as well as physical needs - seems to evoke a lost world . . . Morland's book contains a profound message for the future at a critical moment for general practice and us all.At the college’s threescore and 10, outgoing president Martin Marshall offers a sobering assessment of how the profession is bearing up. “There has to come a point,” Marshall says, “where doctors decide, I can’t do my job any more, and then the situation will spiral out of control. I would use the term crisis: so many parts of the NHS are under such enormous pressure that they are unable to provide the personal care that patients need, unable to provide effective care, and increasingly unable to even provide safe care.”