Interview with Dr. David Wheeler

Dr. David Wheeler is a GP and trains doctors in consultation skills at the Greenwich VTS in southeast London. This interview follows from the article published on 7 September 2001 in The GP Journal  by Dr. David Wheeler. 4150 words


… Dr. John Launer is a particular exponent of this work and he has just written a book about it called “Narrative-based Primary Care”. He’s a GP based in North London and is also a trained family therapist with the Tavistock Centre. Narrative Medicine looks at the patient’s background and biography, so instead of being totally focused in a medical way on the person’s problem, you think about their story and it asks if this is a family story and what it means. What John Launer would say is that there are things we can learn from therapy that we can bring in into our consultation to make the consultation more effective. That is something I now teach to registrars because when they come in into General Practice they learn to totally medicalise problems and find medical solutions to problems they meet. What you end up with so often are two conversations in parallel – the doctor’s medical discourse and the patient’s personal discourse and there is a little bit of cross over now and again, mainly in the form of closed questions – “Where is the pain and how often do you get it?” That’s the doctor working out their own agenda and trying to solve the problem in their own way. Instead what I get them to do is – Stop, listen to what the person is telling you, be curious about what they are telling you and … that’s an interesting story, what does that mean? Let’s go there and find out what that means. It may have nothing to do with what’s on your mind about their chest pain but it could, in fact, give very important clues as to why they are there and what they are really worried about. You just putting the stethoscope to their chest and saying – It’s all normal – is not going to address the problem. This is where we have got to in General Practice – Doing the medical thing is not enough, you have to go into the story and be curious about that.

V: Would that be where the relevance of clowning in the field of medicine is? It isn’t about asking doctors to be clowns in the Patch Adams way. Rather we should ask, what can we learn as doctors from the skills that clowning requires.

D: Yes. There is always this tension in General Practice between the guidelines, targets and medical preciseness and the wooliness of life that we have to deal with. If you deal with people you have to accept that things just don’t fit in boxes as we are led to believe. That’s why I am a GP because I was bored with dealing with things in boxes and I like the challenge of the unknown.

Email me this article

To receive this article (or interview), simply fill in the form below with your email and click submit. The interview will be sent to you straight away.

We send out updates and news of our courses about twice a year. If you do not wish to receive this simply reply with the words unsubscribe in the subject heading.

We do not share our mailing with anyone.