How to Alienate Your Doctor in 10 Easy Steps

Articles in newspapers and magazines often give advice on how to get the best out of your doctor. The idea is to maximize the benefits of a consultation and to relieve pressure on the NHS at the same time.

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But where’s the fun in that?

With a little planning, you could properly annoy your doctor instead. Here’s my advice based on decades working in the NHS, together with one or two favourite tips from my fictional GP colleague Geoff, the doctor in Hampstead Fever.

Hewlett Packard Rapaport Sprague stethoscope

I like to think these are steps almost anyone can take.

1 Prepare for your appointment by not showering or washing for two weeks. Don’t wash your clothes or change your underwear either. With clean clothes, you’re just not playing the game.

2 Bring a list. It should include all the symptoms you’ve had in the last five years. Aim for about 20 or so different complaints.

3 if you don’t have enough symptoms of your own, bring the family. A babe in arms, a couple of hyperactive toddlers, and a deaf granny should do the trick.

4 Kick off the consultation with, “This won’t take a minute, doc.” Which is true. It will take an hour.

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5 To help your doctor’s diagnostic skills, offer a couple of well-chosen newspaper cuttings or internet printouts. You know the kind of story: Vaccines Kill Millions, or New Miracle Cancer Drug. On no account must you allow your GP to dissuade you. After all, Dr Google is so much better than a living breathing doctor with actual qualifications.

6 When the baby’s nappy needs changing, leave the soiled one behind in the doctor’s bin. This ploy is a good one for the summer months.

7 It’s only polite to take your chewing gum out before saying, “Aah.” Leave it in a tidy blob on the GP’s desk.

8 Exhibit your verrucas, ingrown toenails, chilblains, or bunions at every consultation (what do you mean, you don’t have any?). Before you put your sock back on, it’s de rigueur to get it the right way round by shaking it vigorously at your GP.

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9 Don’t ask for an antibiotic for your cold. Demand one. You know your rights. If necessary, remind your doctor that you pay his or her wages.

10 Save your best symptom till last, and mention it only when you’re about to leave. Thus, hand on the doorknob, you can say, “While I’m here, doc…”

FreeImages.com/Robert Eiserloh

With a bit of practice, you should be able to piss your doctor off without even trying.

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For the really perverse who actually want to get the best from their doctor, here’s my advice, along with some wisdom from fellow GP Mark Porter in The Times.

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Warning: A Doctor Rants

Vaccines had a bad press a few years ago, but things have changed, or so I thought. That’s why I was surprised when this week a university student refused the freshers’ dose of meningitis C vaccineFreeImages.com/Antonio Jiménez AlonsoI was even more surprised when he told me that his father, a doctor in another European country, was against vaccination.

What would you have done?  

University students are at higher risk of meningitis. One in four 15-19 year olds carries meningococcal bacteria in the back of the throat, as opposed to one in 10 of the general UK population. And, if you haven’t been a fresher for a while, imagine all that mingling with hundreds of other young people, often in crowded conditions.  

There’s lots of useful info on meningitis, and on vaccines.  Alas, I only know sites for fluent English speakers, and the lad in front of me wasn’t one of them.

I jokingly told him I wanted words with his dad. But in reality that was never going to happen. In general practice there’s barely time for a long discussion with a patient, let alone with family. Photo by Jean Scheijen FreeImages.com/Jean ScheijenConsultation rates with GPs have gone up in the last 20 years to around eight consultations per person a year. Along with that, patient expectations have risen. No bad thing in itself, but it requires more time.

Many areas are bulging with an influx of new patients. London has a particularly mobile population but it’s not the only place where there are migrants, refugees, or simply new housing. Some arrivals speak little English, so interpreters are needed, and the consultation takes twice as long as a result.

The pattern of work has shifted. As hospitals shed more care onto general practice, and send patients home sooner, GPs inevitably must do more. Around 90% of medical care now takes place in surgeries, by GPs, nurses and other members of the health team.

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The structure of health care has changed with the advent of clinical commissioning groups (CCGs). In my view, that work takes a lot of good GPs away from face-to-face patient care.

Professional development makes demands too. I have to keep up to date, and these days I also have to prove it via appraisal and revalidation. People believed something had to be done post-Shipman, so now we spend time counting lots of things that don’t count. I hope that changes, but meanwhile preparing for annual appraisal takes two hours a week.

Providing good medical care is now a real struggle. GPs are retiring, and a sizeable chunk of medics are leaving the country.

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There’s nobody to replace them.

Like many GPs, I teach medical students. That time too must come out of a busy week. But here’s what really worries me about teaching.  

In the last 10 years I’ve noticed that fewer students now want to be GPs. Yet not so long ago new doctors were falling over each other to join practices.

It’s no wonder that doctors in the UK are angry and fed up. New changes imposed by government are likely to make things worse. In many areas, NHS general practice can barely provide a decent service five days a week. How can it stretch to seven days?

I’m not against change. General practice changes all the time. That’s part of its attraction as a speciality. But the developments I’ve lived through now make it almost impossible to do the job properly.

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You may like to read: 

Numbers of NHS doctors registering to work overseas could reach unprecedented record in the Independent, September 21, 2015

A fictional GP reflects on What They Don’t Teach at Medical School

I muse on What Happens when You Become a Doctor.

Easy tweet: What’s wrong with general practice? http://wp.me/p3uiuG-15w A #doctor rants #NHS via @DrCarolCooper