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At the heart of general practice since 1960

Not feeling fluffy any more

Copperfield regrets being so understanding about patients who present too soon

Copperfield regrets being so understanding about patients who present too soon

The other week I said patients were faced with a tricky balancing act in presenting with symptoms not too early but not too late. I suggested there was a fine line between consulting with symptoms of a nanosecond's duration, and my having to intone, 'If only you'd told me about this sooner…' in my proper-doctor voice while filling in one of those 'two-week wait' forms and a DS1500 while I've got the stationery drawer open.

But I take it all back. I was going soft.

I've just finished this morning's telephone triage session and I've never been closer to giving somebody the director's cut boxed-set-only version of the speech that goes: 'I don't need this shit from you or anyone else.'

Call number seven on the list: a little girl has had a cold for two days and needs to see the doctor. I had my standard 'Well, she probably doesn't…' spiel loaded up on my intra-cranial iPod even as I called the number on the screen.

'We're sorry,' said the automated voice. 'We can't accept your call at the moment. Please leave a message.' That pissed me off for a start. If somebody's called in because their kid is sick enough to need to see me PDQ, I don't think it's too much to ask that they answer the bloody phone.

But I remembered the adage that it's the children who suffer when the parents are assholes and that my job is to drag the kid to the shallow end of the cesspit, so I left a nice little message along the lines of 'Ring NHS Direct. They're very nice and very helpful.'

A bald flat-out lie, I admit, but told in the kid's best interests.

And hey, call number eight was waiting, which perhaps would be more interesting.

Five very routine calls later, Receptionist B (one day I will learn their names) pops her head around the door. Mrs Kryzwicki has called back and boy, is she angry.

The textbooks say we should go into 'fluffy' mode when angry punters want to get stuff off their chest, unless they're actually expectorating, when you should stand well clear. And yes, I do know we're supposed to wait at least 30 seconds before interrupting and that some of you would let them cry themselves out. But trust me on this one, you haven't ever heard such a tirade of brain-faded bullshit outside the confines of an Ayurvedic medicine seminar.

Not only was her two-year-old snuffly, she was completely unable to move and more to the point, hadn't slept all night, so how dare I suggest that mother consulted anybody but a fully qualified medic.

Oddly enough, when given the chance to do so, she was far more concerned with putting me straight on how hopeless the NHS is/was/ever shall be.

You know the rest - she was going to write to her MP, she'd never heard of NHS Direct - but she later complained it cost her 30p a minute to call them on her mobile.

Dad brought the kid over. She skipped into and around my consulting room, and after a brief interlude, out again. Dad said: 'She's our daughter; we worry about her.' Which, I guess, made it all alright.

Dr Tony Copperfield is a GP in Essex. You can email him at tony copperfield@hotmail.com

Copperfield

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