Dr Phil Hammond, GP and broadcaster

Medicine may not be the most popular career at present, but it's still a great choice if you enjoy whingeing. Last week, I went out with a group of GPs and we had a round table moan about the consultations we find really difficult. Most of these were unprintable, but a few are worth repeating. (Needless to say, the only solution we came up with about how to cope was to get another round in. Cheers!)

"As a female GP, I see mainly women and children, and men are a rarity. The ones I find difficult are the business-like older men. They make me feel inadequate, and I'm not sure why. Perhaps I don't see enough of them to feel confident, but I find it very hard to tune into their wavelength. I'm sure they perceive me either as a nurse, or of lower status than a male GP, and it's not uncommon for them to try to pull rank over me."

"I'm the token man in my practice, and I get really thrown if a woman comes to see me to discuss HRT. I think 'Why me? What's going on here?' I know it may just be that I've seen them for something else and they're being loyal, or perhaps they prefer seeing a male doctor. But I'm not convinced. I mean, what woman in her right mind would go to a man to discuss vaginal dryness?"

"I find it hard to deal with people who are similar to me. I mean other educated, middle-class professionals. They tend to be more demanding, less grateful, less tolerant of the shortcomings of the NHS. And they're used to being in control – I find it very difficult to get the doctor-patient relationship right."

"I get stressed out by polysymptomatic patients. People who come in with a great list of diffuse symptoms covering practically every body system. A wave of despair comes over me – how the hell can I sort this lot out in 8 minutes?"

"If anyone comes in and demands that 'something must be done' it immediately gets my back up. Usually it's a relative rather than a patient, and often they feel guilty because they themselves haven't done more. It really grates when they live 200 miles away, do a flying visit on mother once a year and then throw a wobbly about the state she's in. It makes me angry because they're implying I'm not doing my best – but I also worry in case I'm not."

"I hate patients who think – or pretend – they are your friends when you don't know them from Adam. They call you by your first name to try to worm their way into your affections. Perhaps they think they'll get better treatment, but it just puts me off."

"Doctors as patients are really stressful, especially when they're consultants. I immediately get stuck in the role of junior colleague and I feel like I'm being tested all the time. It's even worse if they consult about their own specialty – I've just seen a chest physician with a cough.

'What did you say?'

'There's a lot of it about.'

'And?'

'It's probably a virus.' But then I ordered loads of inappropriate tests and X-rays. You know – because he was a consultant "

"I'm very uneasy about seeing members of staff as patients. I mean, they know what we're really like. They hear all the bitching in the coffee room. The doctors are all registered at other practices, but no one else is. Last week I had to do a rectal examination on the practice manager "

"I hate picking up other doctors' mess. Last week, I saw a woman who'd been in hospital for a routine operation. I hadn't had a letter back from the surgeon so I asked, 'What did the doctor tell you?'

'He said I was going home to die.'

She looked quite well on it, but I presumed they'd found something awful when they'd opened her up, so we had a long chat about making wills and pain relief.

When I got back to the surgery, I called the doctor for more details. He was very surprised – and very Australian:

'I told her she was going home today.'"

Guidelines in Practice, February 2002, Volume 5(2)
© 2002 MGP Ltd
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