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The September themed issue of the BJGP leads with Professor Dowrick saying the mainstays of GPs management are prescription of medication and referral for psychological therapy.1 Having trained in the 1980s we were taught our main strength in managing psychological distress was being there to listen. It was considered a core tool and skill. There is considerable debate about the value of both medication and talking therapy in mild or moderate psychological sadness, so it is a shame this basic asset of a GP is ignored or given no weight of value.
Related to this is the trend now for all sorts of diseases to be ‘scored’. In my view, this may distract from the consultation and rarely gives information that is not obtained by normal history taking. In other diseases, such as rheumatoid arthritis, this scoring seems now to be the only outcome of outpatient reviews and highly potent medication is given on that score, not a holistic picture of the patient.
Can we be allowed to practice listening medicine even if we sacrifice QOF points as a result?