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Haslam's view: Talking to patients on the same wavelength

The consulting room couldn't have been more different, but the consultations were just the same. A local radio station had recently gone on air, and I had been recruited to be one of their phone-in doctors.

I figured that it really couldn't be too difficult. After all, what do GPs do all day but talk, without a script, on anything and everything that patients choose to ask us about.

The biggest difference from my normal surgery was having a researcher to screen the calls and a presenter to line up music between consultations. It was a significant difference to the ambience of morning surgery, but the calls still felt real when they started.

The first caller had a bee in her bonnet about milk-free diets and migraine, and couldn't understand why her own GP's eyes seemed to glaze over.

The second caller wondered why one doctor had prescribed penicillin for her son's sore throat, and another refused to do so. She wanted to know how to get a prescription out of him. It made for an interesting discussion.

But towards the end of the programme, I had a caller who seemed very unhappy. She had been to her GP, who hadn't understood her concerns and told her to stop worrying. She couldn't.

I asked her to explain her symptoms and, with a sinking heart, began to recognise both them, and the caller. She was one of my own patients. The unsympathetic doctor she described was me.

The tinny sound coming from her radio must have disguised my voice. I listened, dutifully exploring her ideas, concerns and expectations, and gave her some advice as to what to say to her GP.

She never came back to see me for that problem. Obviously the radio doctor had reassured her. When I did see her next, a couple of months later for a different matter, I was sorely tempted to ask her about it. Discretion seemed to be the wiser course.

I find it really quite bizarre just how indiscreet and open people are prepared to be on national radio and TV about their problems. It is remarkable how often you will catch a phone-in on the radio in which you hear men say things like ‘I'm embarrassed to seek help about this,' and then go on to explain their erectile difficulties or relationship problems to an audience of hundreds of thousands. Perhaps talking to a real human being, face to face, is more threatening than talking to someone at a distance. Maybe there is a lesson for us in our use of telephone consultations.

But I recently had a consultation that worked in quite the opposite way. It started with a phone call from an overweight man who had been a patient of mine for many years.

‘I've just read what you had to say about obesity in this morning's newspaper,' he said. ‘I had better come and see you. I know you've been telling me for years to lose weight, but if you really are an expert, I should start taking you seriously.'

It was tricky, but I had to be honest. ‘Actually, it wasn't me,' I said. ‘There is another David Haslam, who is an expert on obesity. I know it's confusing, but that's how it is.'

‘Thank God,' he said. ‘I won't bother then.' He put the phone down. I didn't know whether to be relieved or guilty.

I think relief probably won.


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

What do GPs do all day but talk, without a script, on anything and everything

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