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Patients can't always have what they want

It is naive to think that a happy patient is a well-looked-after patient ('PCTs urged to promote more switching of GP by patients').

If patients get what they want on demand - for instance antibiotics, sick notes, referrals and investigative procedures - it will result in a happy patient who will sing the GP's praises all the time.

Denying patients these interventions, even if you explain why a test or treatment they have read about in a newspaper or on the internet is not a good idea, results in an unhappy patient.

I have a patient with neurosis who would like prescriptions of inappropriate medications and cancer-phobic patients who, despite psychiatric interventions, still come asking for tests that are not necessary. Changing to a new doctor may result in referral and waste NHS money.

To maintain a happy patient all the time would result in the NHS going bankrupt, as a lot of middle-class patients are already asking for screening tests for many diseases that in most cases are not indicated.

From Dr Yakub Patel, Thornhill Lees, West Yorkshire

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