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At the heart of general practice since 1960

Monday morning

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The Great God of General Practice – actually, make that the Evil Satan – decrees that the following type of consultation shall only happen on a Monday morning, preferably as first appointment. Hence this starter-for-ten cracks of my own skull against the nearest available wall today.

'The doctor at the hospital told me I was to see you to arrange a mammogram.' This from a 78-year-old lady who had attended A&E over the weekend with an obviously musculoskeletal pain in her chest and a good deal of anxiety about a family history of breast cancer – an angst she clearly transmitted to our hero in the casualty department.

So, let’s see...she’s been told she needs a screening test, which is generally applied to asymptomatic women, for a symptom, chest pain, which isn’t a symptom of the thing she’s worried about, which is breast cancer, which she clearly doesn’t have.  And the person whose responsibility it is to order this wrong test for this wrong symptom is, of course, me.

And the fact that I’m a GP with wrinkles borne of 25 years experience whereas he’s basically a white coated zygote counts for sod all, because a) He was in hospital, where all the real medicine takes place and b) He had a stethoscope draped around his neck and so clearly knew what he was talking about.

Deep joy. It takes ten minutes to unravel this little lot and start to have anything like a functional consultation. Ten minutes from a ten minute consultation. And rather more than that from my life expectancy.

Dr Tony Copperfield is a GP in Essex. You can email him at tonycopperfield@hotmail.com and follow him on Twitter @DocCopperfield.

Readers' comments (7)

  • It's called being fobbed off cos he could not be arsed to sort out her concerns !

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  • Happens on regular basis.Patients seem to have this belief (often false) that doctor in hospital setting must be a better doctor and hence his words are gospel and GP MUST do as he says. Unfortunately, they usuall been seen by very junior person who has no idea how to take holistic approach and as that could be time consuming then fobs back to GP causing patient unnecessary worry and not real diagnosis.This also shortens my life expectancy as pick up pieces

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  • I wonder why she went to A&E to sort out her musculoskeletal pain.




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  • Is there always an answer - for what and when patient do, Do you want to hear that - her needs/expectations NOT met her GP's (was it Dr Copperfield's) surgery, what a control freakery

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  • Dr C - that would be really funny if it weren't so painfully real. Ah - pathos.

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  • Patients have choice. Patients are experts at exercising that choice. GPs will not give them the antibiotics/ MRI scan/ latest unlicenced drug reported in the tabloids etc they know they need. Just go to A&E where you can see a young expert in a white coat who will confirm your needs - just get a letter from your GP.

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  • A&E staff frequently send letters diagnosing chest pain as MI, ACS,Acute Coronary Syndrome etc . Subsequent referral proves 9/10 times -chest pain. I predict CHD Registers to be ever increasing.

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From: Copperfield

Dr Tony Copperfield is a jobbing GP in Essex with more than a few chips on his shoulder