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What is Soft Knowledge in General Practice? - Dr Mark Burgin

21/08/19. Dr. Mark Burgin BM BCh (oxon) MRCGP considers the value of knowing about a patient and how anonymous care affects both communication and empowerment.

Soft skills are those parts of the personality of a GP that are essential to develop rapport and an effective working relationship to empower the patient in their life choices.

Soft knowledge are those parts of the GP’s experience of a GP that make the communication relevant for the patient and empower the patient’s understanding.

Soft knowledge is sometimes mistakenly confused with ideas but the difference is between universal facts and those that are true in specific areas.

Whereas it is probably true that you cannot teach soft skills, soft knowledge makes up a good part of the vocational scheme training and almost all the one to one training.

Models of illness

The explanation of an illness could be a series of factual statements that were learnt in medical school or a technical description but neither really address the patient’s needs.

A story, by contrast, helps the patient understand the relationships and meaning behind the warnings and the purpose of the treatment.

GPs prefer the word Model because the word Story is associated with imagination and entertainment, both of which are present in a good model.

Whatever their name the GP perfects their explanation of illness by copying their trainer’s example and developing their own by repetition and keeping what works.

Cultural norms and language

Communication difficulties due to an incomplete shared language are generally easy to overcome with non-verbal and verbal signalling and a translate program.

More difficult to bridge are the gaps between cultures that arise from different interests, use of idiomatic phrases and social expectations.

Cultures are based upon interests not nationality and even token efforts to have to take an interest, comply with social conventions or use the other’s language can be effective.

Knowledge about a family or local employer or even health beliefs in the GP practice may be essential to understanding a cue or persuading a patient to trust.

Psychosocial patterns

Patients may not be able to express what is happening to them using language or even give a hint using nonverbal or idiomatic phrases.

The GP needs soft knowledge to be able to read the patterns of psychological and social factors and determine what is happening and causing the patient’s problems.

This knowledge frequently comes from listening to those with experience from contact with the family and the local community in addition to the patient themselves.

Without a glossary of the local symbolic meanings the GP is forced to put their own interpretations of the reasons why they are behaving in that way.

Conclusions

Soft knowledge is not valued because it is difficult to measure, and both communication and empowerment are seen as the GP’s fault if they go wrong.

The experienced GP and the team know a lot about their community, how they communicate, what problems they face and how to explain things to them.

When that team is assimilated into a larger area their knowledge is diluted and has less relevance and eventually is lost when care becomes anonymous.

Using a one-size-fits-all approach can lead to suspicions that the GP is making assumptions based upon partial information which in turn causes resistance and loss of trust.

Doctor Mark Burgin, BM BCh (oxon) MRCGP is on the General Practitioner Specialist Register and audits medical expert reports.

Dr. Burgin can be contacted This email address is being protected from spambots. You need JavaScript enabled to view it. and 0845 331 3304 website drmarkburgin.co.uk

Image: public domain from https://pixabay.com/en/doctor-medical-medicine-health-563428/