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GP pioneer of patient centred medicine
When he was a 7 year old boy, Philip Hopkins made his decision to become a doctor, inspired by the surgeon looking after him who presented him with a Book of Heroes. Philip went on to a fulfilling career spanning five decades. He also became an inspiration for others. These early themes, determination, courage, and inspiration informed his entire professional life, and in challenging times sustained him personally.
Philip Hopkins was a founding member of the Royal College of General Practitioners and was awarded its fellowship in 1969. He was the founder and first president of the Balint Society. He was also a founding member of the Psychomatic Research Society. He pioneered cryosurgery in general practice in the United Kingdom and was elected a fellow of the American College of Cryosurgery. He was a dedicated man who enjoyed wide ranging professional interests, and for whom medicine and general practice was a way of life.
Philip began his training in medicine at Guy's Hospital during the second world war. At this time he took on additional duties as an air raid warden and was stationed on the roof of the hospital. There he spent many nights kicking away firebombs in the available 10 s before explosion, a different sort of training and not for the fainthearted. This seemed to set the scene for all that lay ahead because in his lifelong dealings with the National Health Service, with colleagues, and in his care of his patients, Philip was never fainthearted.
After qualifying he did medical and surgical house jobs at Guy's and King George Hospital, Ilford. Philip then served in the Royal Army Medical Corps (1946-8). He was posted to Egypt, where he worked as a graded orthopaedic surgeon. It was during this period of “bone carpentry,” as he called it, that Philip became increasingly interested in the emotional lives of his patients. Many of these soldiers felt isolated and depressed, desperate to be reunited with their loved ones and struggling with the demands being made on them. Reprimanded by his commanding officer for sending too many men back home, Philip often retorted, “I'm not a soldier, I'm a doctor.”
After the birth of his first daughter, Carole, he returned to England. He worked as an orthopaedic and then medical registrar. Working as a locum for a local general practitioner eventually resulted in Philip's decision to enter general practice. Soon after Philip bought a house with a practice and inherited a panel of 1400 patients. This was just before the formation of the National Health Service. He was paid seven shillings and sixpence for each patient and worked hard to build up the practice to a level that would eventually support his growing family, which now included his two other daughters, Laura and Gina.
The 1950s was an exciting time in general practice. Doctors were seeking to understand the emotional relationship between them and their patients with the intention of making their work more interesting, effective, and rewarding. At that time there was no vocational training in general practice. Impressed by a lecture on “The psychological problems of general practice” given by the renowned psychoanalyst Michael Balint, Philip deepened his commitment to treating the whole person. He then met Michael and Enid Balint, whose ideas greatly influenced Philip's work and professional life.
The original Balint groups explored the nature of the interview with the patient. Emphasis was placed on understanding the patient's transference to the general practitioner, and the doctor's counter -transference feelings. When a particularly puzzling problem emerged, Philip would select one of his patients for a long interview to explore his or her symptoms from a psychological perspective. He became a tireless champion of the Balint method and encouraged several generations of young doctors to join Balint groups and learn about patient centred medicine. For 25 years he edited the journal of the Balint Society and published many papers and a number of books on the subject. Today the society is still flourishing. Balint groups continue to influence the work of general practitioners in the United Kingdom and in Germany and the United States, where they particularly thrive. But Philip was much more than a psychologically minded general practitioner. He particularly enjoyed diagnostic puzzles, and learning about drug trials and new minor surgery techniques and was an advocate of thorough clinical investigation and holistic diagnosis. As a general practitioner he enjoyed innovation and being challenged intellectually.
Other interests included the Hunterian Society, which awarded him a gold medal for its essay prize in 1954. He was elected president of the Medical Practitioners Union (1960-3), accompanying its deputation to the Soviet Union and East Germany.
Philip's organisation of the medical world international conference as part of the Medical Practitioners Union's “Organising family doctor care” was influential in the first meeting of Colleges of General Practice held in Montreal in 1964. In a letter to John Hunt (later Lord Hunt, first secretary of the Royal College of General Practitioners) he wrote: “My concern is, and always has been the same as yours, namely to improve and develop general practice to its utmost best.” Also active locally during the 1950s and 1960s he held the posts of honorary secretary, treasurer, chairman, and provost of the North London College Faculty. He campaigned for postgraduate courses to be organised by general practitioners, not hospitals.
Philip was clinical assistant, Department of Psychiatry, Hampstead General Hospital (Royal Free Group), and Marlborough Day Hospital, London. He was local divisional police surgeon (1950-70) and an active member of the Hampstead Medical Society.
In the mid-1970s he married for the second time and his son, Michael, was born. Philip was diagnosed with cancer of the oesophagus and spent 18 months in the Royal Free Hospital. During this period he underwent 17 operations and several times was close to death. It seemed certain he would never return to his practice but Philip had other ideas, and returned to his home and practice at “Hopkins House.”
Illness did not diminish Philip's enthusiasm for his work. The practice continued to expand and he developed a new interest in cryosurgery. He became impressed with the use of liquid nitrogen in the treatment of many skin disorders, including skin cancers, and pioneered its use in the United Kingdom over the next 28 years. He successfully treated over 35 000 skin lesions in that time and was elected fellow of the American College of Cryosurgery in 1978. He travelled to conferences in the US and corresponded extensively with other specialists.
With great reluctance Philip retired in 1991 and continued in private general practice until December 2000.
At “Hopkins House” Philip and his wife Sue created an environment where patients and professionals alike were listened to and cared for. Philip was a remarkable man, totally passionate about medicine, a lively, warm, generous doctor and kind colleague and teacher to many for over four decades. Today, his white coat still hangs on the door of his consulting room and among the endless rows of books, photographs, and memorabilia is a name badge, which simply states: Philip Hopkins—Independent Physician.
Philip Hopkins, general practitioner (b 1 November 1920; q Guy's Hospital, London, 1943; FRCGP, FACC), died from bronchopneumonia secondary to cerebrovascular disease and neo-oesophageal stricture on 31 December 2006.
He leaves his second wife, Sue; four children; and six grandchildren.