20th December 2023
This is a conversation between Dr Linda Edwards and Professor Hillary Pinnock, Professor Hillary is a long-standing GP and a clinical academic at the University of Edinburgh. Her passions are around supporting self-management and supporting self-management and implementation research.
I made a decision to study medicine so clearly that was a defining moment I love science and I love biology and it just seen a good career pathway to go down I don’t think at that point and I decided whether I was going into Primary Care or secondary care specialist I had made no decisions on that
at all but I found myself in primary care and have loved it been as you said I think for many many years as part of 45 years as a GP in several different practices I’ve always loved science I love projects I love managing projects coming out with answers so possibly it was not entirely surprising that around my 40s I started getting involved with academic research this actually is one of the many advantages of being a woman I had a young family and I opted to work part-time, of course there comes a time where they start to not need mum quite as much as they did and I filled my time with audit work locally and then later on with research so I kind of sidled my way into an academic career and then as time has gone on that’s become more and more important so I’ve gradually shifted from being one time I was a three quarters time GP in a day a week as an academic now I’m the other way around I have a day a week in my clinical practice and I’m the rest of my time is academic and research so it’s just kind of happened
I think you lead from the front, you have to lead and the buck stops with me as a leader in the end it’s my responsibility but I have long since realise that there are many people in my teams who know more than I do about all sorts of things you know whether that’s statistics I don’t pretend to be able to do statistics anything more than extremely basic so I have statisticians and turn to them. The health economy is something that’s so important and it’s I can’t do that I have colleagues to help me, behaviour change, I’m working increasingly with health psychologists and they can teach me a lot so if it’s behaviour change I need to listen to them. Education as you know Linda we’ve been working with experts from education for health to advise me on education I don’t pretend to know how to put together an educational package management, some of the finance is I need somebody to explain the spreadsheet to me so yes the buck stops with me as the leader and principal investigator in a project but if we go to make the right decisions I need to be collegiate and listen to the team.
I wouldn’t say just one you know, I have two colleagues I would just highlight perhaps the first was very much as a domestic level when I was a very young mom in fact just about to be a young mum and I was thinking how am I going to cope with a baby. In my practice was a lady who had five children, two parents and a dog and I thought to myself would you know if she could do all that and manage, that I think probably can manage with one baby. That was a role model many years ago now academic was probably a colleague in the next practice I moved into, who was a GP trainer and I look quite a lot from him about you know following dreams really because he was always very keen for me to take the approach of if you want to do this then do it. I’m going back now to 1980s and I said you know I think we need to be setting up asthma clinics and diabetic clinics, and he said well do it then, do you need some training what do you want to do? So, I think that kind of attitude was something I learnt from him. Probably the person whose influence would be professor Aziz Shaik who I suspect you know many people know as he is has always been a mentor to me he’s supervised my MD thesis and he’s very very busy people but he’s always supportive.
I think the first thing to say is to acknowledge uncertainty you need to be very confident in acknowledging what you don’t know and what isn’t clear yet. Our politicians make this mistake they feel they’ve got to know the answer I’ll sometimes answers are clear sometimes you’ve been there before you know what the answer is, its very clear but sometimes it is not clear what the answer is and whether that’s in clinical practice and I’m seeing the patient and I’m thinking I’m not quite sure about this just making a diagnosis of asthma is really not easy, it’s not always clear and I think sharing that uncertainty in a confident way, not in a fluster, but this is challenging, and this is how we’re going to sort it out and that might mean looking something up that might be reading something it might mean context of asthma to come back to that it might be look if this is a variable condition. It’s about why I don’t know the answer and this is how we can move forward in order to find an answer and we’ll do this together and seeking advice and recognising that sometimes the decision you take today is not necessarily the decision that’s going to be rights in a week’s time two weeks time six months time and that there may be things changed, things evolved.
I find it difficult to say no, I like saying yes! I think grasping opportunities is what makes career work spotting opportunities and saying yes to them but the other side of that of course is that you then have to learn to say no sometimes. The most difficult decision, no it was an inevitable decision in the end but the one that I found most difficult to execute was when I decided to retire I use that word very carefully because I decided to retire as an Equity partner in the practice I was half time and I went down to that one day a week as a salary partner and that felt like a huge stopping and I found that extremely difficult to actually execute it was absolutely the right decision I’m delighted I did it for 10 years ago now it’s been you know it enabled me to increase the academic work which I absolutely love so it was the right decision but it was not an easy one.
My academic work which is so varied it’s not doing the same thing each day my projects are all different and increasingly I’m doing work globally which seems so exciting it’s so interesting and challenging, so what keeps me on the ground, family really I’ve got two lovely grandchildren and you cannot fail to be distracted by them and I really do want to do things for them so you know that definitely keeps me very balanced.
The words that come into mind are taking opportunities as I said right beginning I planned career path that just happened I got into my forties I was part-time in general practice there which group but it was saying that group of people we can do research workshop I signed up for it and out of that came the telephone review trial that got into the BMJ out of which I actually then wrote this dissertation for my thesis and that introduced me to a lot of people including Aziz that I mentioned I then there was an opportunity arose for to join his team in Edinburgh so I took that opportunity, then came the opportunity with international Primary Care groups so I sort of put my hand up and suggested I’ll help do that, it’s taking opportunities and more recently the European Respiratory Society I was asked to stand for originally just as a group chair and I said all well yes okay and that led me on some other things so yes it’s opportunities seeing opportunities going for them and delivering of course, it’s no good going to say yes and they’re not delivering.
Enjoy it, get excited by it, be interested in it. The pleasure I get from a patient, who just a few weeks ago said you won’t remember t me but 20 years ago you look after my mother when she was dying stayed with somebody so enjoy what you’re doing recognize that you can make a difference even if you don’t always see it every day you are making difference to people’s lives. So enjoy a career in the Health Service being enquiring, don’t assume that what you’ve always done is right so think about how it could be done better be enquiring about what you do and go for opportunities look for opportunities join professional groups and professional societies where you can exchange ideas and just take yourself out to your day-to-day so all of that and say yes to opportunities excites you go for it think of think later how you’re going to do it, say yes and then work it out!