A recent study from the US has found that most people rate the doctor’s personality and the quality of their relationship with him or her as most important when choosing a doctor.

when asked what they thought was the most important factor in a “high quality doctor,” most people cited factors related to the doctor’s personality and the quality of the doctor-patient relationship, such as whether a doctor is attentive or caring or has a good bedside manner

Does this surprise you?

It doesn’t surprise me.

I think far too little weight is given to the human factors in health care – who the person is – both the individual, unique patient, and the individual, unique doctor.

Not only is every human being unique, but every relationship is unique and I learned early in my career that each partner in a GP Practice would attract a distinct cohort of patients. In fact, we noted that we could all tell exactly who was on holiday from the particular patients who came to see us in our colleague’s absence. There just is no such thing as any one doctor being the “best” doctor for every single patient.

Whilst the statistics-fanatics seem to prefer numbers and think numbers can be applied across the board as if human uniqueness didn’t exist, in the real world, human beings make choices in human ways (not computer/robot ways)

When it comes to competences, then all doctors should do their best to develop their skills and their knowledge continuously. That’s what good, reflective practice is about. Personalised feedback would certainly be useful, but reporting should be done according to the priorities which patients AND colleagues set – and that would include the relationship skills as well as competences in techniques.

Big rock beach

I noticed this huge rock on a beach recently (OK, I agree, how could you NOT notice it!?)

I suppose I was a little surprised that some people had chosen to sit right in front of it……were they hoping to shelter from the wind? Or were they seeking some shade from the sun? Or, maybe, just maybe, they were working up to having a go at shoving it out of the way?

I’m guessing a LOT of people have wondered about moving that rock. I mean, there it is, sitting RIGHT in the middle of beach! So, why hasn’t anybody done it yet?

Then I got the answer – it’s down to “structured procrastination” –  as John Perry describes it -

All procrastinators put off things they have to do. Structured procrastination is the art of making this bad trait work for you. The key idea is that procrastinating does not mean doing absolutely nothing. Procrastinators seldom do absolutely nothing; they do marginally useful things, like gardening or sharpening pencils or making a diagram of how they will reorganize their files when they get around to it.

So maybe the people sitting on the beach there are doing some marginally useful things instead – like increasing their vitamin D levels by sitting in the sunshine, or measuring the temperature to check for global warming, or counting seagulls to for an RSPB environmental monitoring project, or……..

Or maybe this is not about procrastination at all, maybe it’s about being fully paid up members of the slow movement, like Christopher Richards, the founder of the International Institute for Not Doing Much (Christopher, thanks for sending me an email a few years back, I think my reply might be heading your way soon).

What an inspiration for slowness……..watching a rock change!

Hope you’re able to enjoy a nice slow holiday this summer (and if you haven’t figured out how to use structured procrastination to actually book that holiday up yet, check out John Perry’s book, “The Art of Procrastination” – just make sure you’ve got “Buy with 1-click” switched on)


Twilight over the estuary

In the A to Z of Becoming a “D” verb is “de-clutter”.

What does it mean to “de-clutter”? It’s going to mean something different to each of us. I’m not making the case here for a physical environment which is minimalist (although my personal preference tends towards minimalism).

This photo of the sea at twilight looks calm and open to me. That’s the feeling I want to get when I de-clutter.

It’s amazing how much “stuff” we accumulate unconsciously – both physical stuff in our rooms, our cupboards, shelves, drawers (and floors!) – and mental stuff in our heads which we carry around with us everywhere.

De-cluttering for me is just a process of making conscious choices. Do I really want to keep that (whatever “it” is) and if I do, do I want to keep it just there where it is at the moment. I find when I de-clutter I do throw a lot of things away – de-cluttering the bookshelf consists of putting into bags books I have read which I know I’ll never want to read again and then taking those books to a charity shop, or giving them away to friends and relatives. De-cluttering a room is often more a process of tidying rather than throwing, or giving, anything away. De-cluttering a wardrobe involves trying clothes on to see if they fit (and realistically am I EVER going to be that size again??) and if they don’t, out they go.

De-cluttering might take effort but once you start the liberation and freedom and space which starts to emerge can be quite thrilling.

De-cluttering your mind is something else again. Meditation practices definitely help to de-clutter the mind. Just taking the time to watch the stuff (the thoughts) which are looping through your mind and watching them go is a de-cluttering all to itself.

Go on, make some space – in your room, in your house, in your head!

Look again

What do you see?


I saw the gable ends of a couple of blocks of flats.

I saw a woman looking out of her window and a man with a rugby ball in his hand standing on his balcony.

I saw the see through the arches.

Then I looked again……..

I saw a mural.

This provokes two thoughts for me -

Firstly, how often do we take the time to really see what we can see? What’s familiar is often worth a brand new look.

Secondly, how much attention do we pay to the creation of our lived, physical environments?

First and last

There’s a classical teaching about living life to the full which says to embrace each experience as if it is the very first time you are having this experience (which is true…..every experience you have today is for the first time). This is quite like the mindfulness or awareness teachings which tell us to be fully present, as fully aware as possible, as much as we can. This, in fact, is the essence of “heroes not zombies” – it’s about waking up, living consciously and not on autopilot all the time.

There’s another teaching which says to embrace each experience as if it is the very last time you will be having this experience (which is also true……you will never have exactly the experiences you have today ever again).

I find both these teachings come to mind as the sun rises and the sun sets (or Earth Falls and Earth Risings?). Have you ever seen the movie, “City of Angels”? (an American re-make of Wim Wenders, “Wings of Desire”) There are beautiful scenes there where the angels all gather on the beach each morning to experience the sunrise. To be quite honest, I’m not out and about experiencing sunrises all that often, but the other end of the day, sunset, is an equally entrancing event.

If you are ever somewhere where you have an unobstructed view of the sun setting, you’ll likely see that you aren’t experiencing the sunset alone. I was lucky the other day to watch some spectacular sunsets from Biarritz, watching the sun sinking below the horizon of the Atlantic Ocean (and, no, I didn’t see any green rays)

The play of the light on the waves and the wet sand were amazing…..



Sun set light on surf

Low sun on sand

Sunset Biarritz

Setting sun up close


Live life fully today – living every single experience for the first time and the last time.

Verbs into nouns

Osho, when talking about relationships, makes the point that “relationship” is a noun, whereas “relating” is a verb.

I understand the importance of our doing words, our actions and choices as represented by the verbs we use. Have a look on this blog for the “A to Z of Becoming”, or read about William Glasser’s “Choice theory” to explore more about the verbs in your life.

Osho adds another interesting element to the importance of understanding the difference between verbs and nouns. He says verbs are uncertain and nouns are an attempt to be certain.

That made me think of the Creation myth where God told Man to name the other creatures and so have “dominion over them”. This element of control is typical of the left hemisphere approach to the world, as described by Iain McGilchrist – it’s a process of “grasping”, getting a handle on, or getting a hold of something.

Nouns describe objects. They turn activities and experiences into things. Things which can be measured, known and controlled.

But Life is a process, not a thing, and living, loving or relating can never be fully known, grasped or controlled.

It can be exciting to let go of the delusions of certainty and to relish with heightened pleasure the living fully in this present moment.



I’m sure we all fall into routines or habits quite easily. As I was having breakfast yesterday here in Biarritz (on holiday!) I got to thinking about how our start to the day influences our experience of the whole day.

I imagine that starting the day with an expresso and a croissant taking in a view like this might set up a good experience for quite a long time!

But I wonder what our routine morning starts set up?

Do you start the day in a rush?

Do you start slowly?

Do you have breakfast or grab something on the run? Or do you meet up with friends or colleagues in the same cafe each day?

Do you watch, listen to, or read the news, and fill your mind with stories of deaths, disasters and crimes?

Do you start with meditation, or exercise, or reading (and if so, what do like to read first thing?)

However you start your day, why not try changing something…..and see how that feels?


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