Taking primary care to the patient

By Dr Ayan Panja
Street doctor

Dr Panja examines a patient

A new BBC series follows family doctors as they take to the streets to offer primary care to patients on their home ground.

Among the intrepid team was Dr Ayan Panja, who describes the benefits - and disadvantages - of the project.

When I first got involved in the BBC's project to take us out of our surgeries to treat the public wherever they happened to be, I was genuinely excited.

Just imagine being able to see a GP at your own place of work or in the high street during your lunch break - it's phenomenal.

And for us as GPs it has also been a new experience. There is no desk or examination couch and no practice nurse or reception staff. Just you, your Street Doctor bag, the sign and your patient.

And it could be anywhere: at a crisp factory, a coal mine, a rugby match, in the town centre or at the zoo.

The willingness of the public to consult us has been overwhelming.

The breadth of people and their ailments has been eclectic - everything from asthma to golfer's elbow and even one case of skin cancer.

But apart from diagnosing, treating and screening for conditions, one of our main tasks has been health promotion and offering lifestyle advice.

Risk factors

As GPs we actively try to improve people's long-term health and so we advised many people we met about how to reduce risk factors for heart disease, stroke and diabetes.

Seeing people in their place of work has its advantages. In particular it is easy to see for yourself which factors play a part in certain conditions.

The doctors travelled to many locations

For instance, I saw a chap in one of Belfast's top restaurants who had spent seven years training to be a chef, only to find that he suffered with very bad hand dermatitis.

In fact doctors had told him to change career, as his hands were sensitive to most foods.

We chatted about moisturising and steroid ointments but then I explained that the biggest change for him had to be to stop smoking.

Stopping smoking dramatically improves inflammatory skin conditions (let alone all the other health benefits) and I was pleased to hear later that he has really cut down the cigarettes and that his hands are already much better.

Thumb injuries

In Leeds we saw two butchers with very similar thumb injuries.

It's almost like you only get half the picture in the surgery Dr Ayan Panja

Seeing them both in the workplace made us wonder whether the problem could be work-related.

It turned out the injuries were caused by the way they were using cleavers.

In our own surgeries, we would only be able to find out these details by asking questions but actually seeing it first hand is unbeatable. It's almost like you only get half the picture in the surgery.

But dealing with the health of people who are not our own patients doesn't afford us the usual GP luxury of being able to follow everyone up at the drop of a hat.

We were able to follow up only a few cases but people were invited to contact us afterwards if they needed to.

In my own practice, patients are able to come and see me again with relative ease, but this is clearly not an option for a Street Doctor patient who lives in Belfast!

I hope our team have had a really positive impact on people's health and their lives and, judging from the feedback so far, I think we have.

One lady, Marie, said to us: "I feel like you've saved my life, really."

She was suffering from intractable headaches and Dr Jonty found her blood pressure was very high.

She's now on treatment, the headaches have gone and she has greatly reduced her risk of stroke.

That's what it's all about.

Street Doctor will be broadcast on Thursday 11 January on BBC One at 1900 GMT.