Dr Phil Hammond, GP, lecturer and presenter of BBC2's Trust Me, I'm a Doctor

Do you have to? If no, don't – unless you want to. But if yes, progress

Why would you have to? Because (a) it's your turn; (b) it's for charity; or (c) you're desperate to make a career out of it so you can get out of medicine.

If (a), then it's likely you're a member of some club or other – what you say will be governed by some bizarre set of rituals – who you honour, who you give thanks to, how much of your calf musculature you're allowed to expose. Betray the rituals and you will cause grave offence.

If (b), you can't go wrong. The audience know you're giving up your time for a worthy cause and are generally forgiving.

But if you are, or intend to be, a professional speaker and charge a fee (c), then they will expect a lot more. Which brings me nicely on to…

How well do you know your audience? The secret of any speech is to ring bells with the audience. As in all forms of communication, the context is everything. What slips down a treat in Guy's bar at midnight will be greeted with angina and apoplexy at the Thistle Tea Rooms at midday. If you know your audience, talk about them, rather than you. If you don't, ask for some advance information and then mingle during dinner. Anything that shows you've made an effort to tailor your material is usually appreciated.

Rehearsal The more you rehearse, the less you'll need cue cards and the easier it is to interact with the audience. Rehearsing on your own helps the memory, but it's better to do it in front of your spouse, nanny or anyone you can drag in off the street. It'll be excruciatingly embarrassing at first, but if you can survive that, you'll survive anything.

Keep it short Most humour benefits from editing (remember brevity is the whole of wit) and it's far better to leave your audience wanting more. So 10 minutes of good material is far better than 30 minutes of mediocre musing.

Experienced speakers claim to alter their material according to the audience's response, but this takes some doing. However, if someone has a cyanotic coughing fit or gives birth on the top table, you'd be a fool not to incorporate it into your routine. Remember though that you're a doctor – don't look on and laugh as someone expires at your feet.

Never forget you're a doctor… Doctors have access to an enormous amount of privileged information and experience, much of which makes great comedy. However, confidentiality must always be sacrosanct, so if your material is based in reality, it needs to be heavily disguised. If you've just done a smear and a strawberry fell out, changing it to a raspberry isn't sufficient.

Be seen and be heard Many a speech has been ruined because there wasn't a microphone, or it didn't work or the speaker was hidden behind a pillar. Find out about the venue in advance, ask for a microphone for all but the smallest audiences, and try it out before the speech. Keep the mike close to your mouth at all times.

Wait until after coffee Don't start while food is being served – no-one will pay attention. And don't get pissed. You lose insight, memory, timing and self-control. A horrible sight!

Hit the President A risky strategy this, but I find that gentle hectoring of the most senior person present pays dividends. Ask him if he can recite the company's mission statement or the Royal College guidelines on intimate examinations. My guess is he won't be able to do either so don't make him squirm too much. There's a fine line between comedy and cruelty.

Pace yourself and keep going… Don't go so fast that the audience doesn't have time to laugh. And if they don't, don't ever explain your jokes or get annoyed with them.

If someone heckles you, either ignore it or hit back hard (e.g. last time I saw a tie like that it was attached to a placenta). Look as if you're enjoying it, even if you're not. And end on a good gag.

Now get pissed… You've earned it. But don't drive home.

  • A hugely controversial must-have book of the series Trust Me, I'm a Doctor is published by Metro on 4 March. Price £9.99. Freefone number for credit/debit cards 0500 418419.

Guidelines in Practice, March 1999, Volume 2
© 1999 MGP Ltd
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