He decided to retire nearly 10 years ago, and although he felt it difficult to leave his patients behind, he felt it was the right time for him to move on.

“The truth is, I miss it. I don't miss all the pressure, but I really miss the people. I do often have feelings of guilt about leaving the profession because I sometimes think that I have more to give. Interestingly, I think I still have that caring need in me and I'm glad I retired because that caring role has been fulfilled to a large degree by my family. My mother-in-law has Alzheimer's, and we've been supporting my brother who has mental health issues; plus now, we have a seven-month-old little rescue dog, who takes up a lot of my energy at times.”

Dan’s mother was a nurse and his father was a doctor, so the family had an ethos of caring for others. His ‘Nain’ (grandmother) was a district midwife who covered much of Caernarfonshire, cycling around on a bike. With the medical profession being a big part of his life from a young age, Dan went into medicine at Cambridge and then St. Thomas's in London. He particularly enjoyed his clinical training.

“As a child growing up with my father as a GP in Harrogate, in the 1960s, we would have people knocking on the back door with nails stuck in their fingers and all sorts of minor injuries and traumas. My father would be getting up in the middle of the night to drive off to Pateley Bridge to see patients. I think if my father had a fault, it was caring too much. As my medical career progressed, I became far more interested in people rather than diseases. I became interested in the whole holistic sense of caring which led me to be drawn to training in general practice.”

Through his time in general practice, he soon realised that the closer you get to people, the more pain you absorb. Certain situations became emotional as a lot of the patients were Dan’s friends, not just people with illnesses. 

“I can say that general practice did, to some degree, chew me up and spit me out in that it became all-consuming, because that relationship with the patient was so fundamental. It could be overwhelming. It led to something of a paradox because I realised that unless you get close to people, you don't get near their problems. My experience was that people, by and large, came to see me only when they needed to. Every consultation was a building block in my relationship with that person. They were all important because that's where the trust was built. Patients would come with something relatively minor and have their hand on the door handle about to leave when they would suddenly turn around and say, ‘Whilst I'm here, doctor, what do you think about this?’ and a great number of times that that was actually the most important thing.”

Over the years he has learned that not all painkillers and anti-nausea drugs can have the same effects on different people. In terms of palliative care, sometimes alternatives to drug treatments, including surgery and radiotherapy, can be appropriate to treat pain. He believes that working as a team during end-of-life care is essential and thinks GPs have an important role to play in helping to coordinate services.

“GPs are not consultants, we're not specialists, we must recognise the limits of our competence and abilities. My experience as a general practitioner was that it was vital to discuss with the local palliative care team even if it's just to phone them up and give an overview of the patient. The local district nurses are absolutely invaluable in the support that they give to patients in terminal care, as are also the palliative care nurses. They are highly skilled people. I tried to get them involved early on, so they knew about the patient.”

The importance of communication and a handover of information within the surgery is so important to Dan and he believes that all partners who are involved with the care of that patient should know fully about them. For continued care, the significance of things like pain management self assessment scales can be very important. These help a patient to measure their pain regularly so the care team can assess the response to any interventions.