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Independents' Day

Fear and loathing on the home visit

The home visit provides a real insight into patients' lives – and makes for a great anecdote or two

The home visit provides a real insight into patients' lives – and makes for a great anecdote or two

The home visit has been a unique part of my registrar training, and I imagine this goes for a lot of us. It offers so many opportunities for education and amusement.

Just yesterday I visited an older chap stuck in bed with a UTI. He was febrile and, shall we say, 'pleasantly confused'. His neighbour said that this had happened before and she was happy enough to monitor the antibiotics. She asked if I would also look at the way he was walking before I left. At the nod from me he threw back the covers, put on a pair of slippers (making these and his mad grin the only things he was wearing) and began hopping about the room making a hooting noise.

This, I thought to myself, is why I'm becoming a GP.

Wallpaper headaches
The home visit also gives you a feel for how your patients live, which adds considerable depth to your consultations and understanding. They come to you saying: 'I've got a headache, doctor.' And you think: 'I've seen the colour of your bedroom walls. I'm not surprised.'

They say: 'I'm struggling with the gardening, doctor,' and you reply: 'I think I'd struggle with two acres as well. That reminds me, we've got a five-a-side coming up and I was wondering if we could use your patch?'

Exercise, exercise!
A couple of senior registrars told me I should invest in a satellite navigation system. I invested in a map. Neither one would have helped with my final little episode.

I was making my way slowly along a road in our green and leafy suburb. All of the houses had names, rather than numbers (how convenient). On a previous occasion I was guided to the right house by two ambulances with flashing lights parked outside: handy, but not necessarily a good sign. This time I was tipped off by the patient's husband pacing back and forth in front of their drive wringing his hands. I parked and got out, looking very much the part in a long black coat and tie.

'I'm very worried about her, doctor. She's never ill,' he said. I nodded sagely, reaching into the boot for my bag. I walked ahead of him into the house, sombre, listening to his murmured concerns. He directed me up the darkened stairs and I swung my bag in front of me, holding it aloft as I ascended. I then made a small shock of discovery simultaneous to the husband's question,'Is that your gym bag, doctor?'

It was. How mortifying, but still I had to fight off the impulse to cry out: 'Exercise, man! That's what she needs! Now take these two running shoes and call me in the morning.'

Dr Geoff Tipper is a GP registrar in Maidenhead, Berkshire

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