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A faulty production line

Haslam's view: Is the coffee break a risk too far?

I wish they would make their minds up about coffee. One day it's good for you, the next it's blamed for increasing your risk of heart attack, cancer or miscarriage.

To some extent, coffee is no different from countless other everyday products. After all, in the eyes of certain daily newspapers there is nothing that isn't either a potential cure for, or the undeniable cause of, cancer. But coffee has a particular place in my heart, perhaps too literally, and I would like to know where we really stand.

It's all thoroughly confusing, particularly as the reports never seem to make it clear exactly what they mean by ‘coffee'. There is a world of difference between a mighty double espresso and a mug of instant coffee. But the headlines always say ‘More than two cups of coffee is…', whatever the problem turns out to be this week.

I used to worry about how much coffee I drink when I'm doing the doctoring, but then I realised that most of them go cold on my desk and eventually get tipped away only half drunk. I'm sure that risk, addiction and habituation depend on the liquid actually passing one's lips. Simply putting it in a mug and ignoring it must be a relatively risk-free activity.

But the coffee break is an essential part of every general practice. If the day is going well, you get a rare chance to sit down with colleagues and staff and have a break from the never-ending ideas, concerns and expectations of our patients. And if it isn't going well, it gives you a chance to catch up, with or without the coffee.

I have always believed that if things are going badly the secret of survival is, bizarrely, to slow down rather than to speed up. Speeding up is usually a recipe for more stress, more problems and more adrenaline. The last thing a calm consultation needs is too much adrenaline in both the doctor and the patient.

And there appear to be worldwide rituals that are associated with coffee time in a GP's practice. I've been privileged to visit general practices in many countries, including Brunei, Kosovo, Oman and Hong Kong. And in each of them cake appeared at coffee time to celebrate a receptionist's birthday. It's a rather wonderful symbol of worldwide primary care, and intriguing that it appears to be universal. But then birthdays, receptionists, general practice and coffee all really matter.

In my practice, and I suspect we aren't alone, we also have cakes to celebrate the fact that it is Friday, occasionally to note that it is Monday and we need cheering up, and any one of a number of other reasons.

But is it all safe? Shouldn't we be sitting around supping cups of warm water or fruit juice? Is all that caffeine a risk too far?

Well – to be blunt – I don't care if it is. I do get heartily sick of everything we do, eat or drink being labelled as a danger or a risk. Life is for living.

A total absence of any risk seems a recipe for existence, rather than life. And it also seems that the exclusion of all risk is, in a bizarre way, a risk in itself. Children who are forbidden from playing outdoors ‘because of the risk' end up physically, psychologically and socially harmed, which seems a pretty big risk in itself.

So mine's a skinny cappuccino with chocolate sprinkles.


Professor David Haslam CBE
GP, Ramsey, Cambridgeshire; President, Royal College of General Practitioners; national clinical adviser to the Healthcare Commission; and Visiting Professor at de Montfort University, Leicester

Haslam's view A total absence of any risk seems a recipe for existence, rather than life

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