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Treating a chronic sense of self-entitlement

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She’s sunburnt, elephantine and heavily tattooed. Which may or may not be relevant, but is a fact. She’s also new to the surgery.

Your freedom lies in one word, and that word is, “No”

Waiving all the conventional niceties, she launches straight in: ‘I need a prescription for all my usual meds plus some extra sleepers. And supplies of milk for the baby. My sickie’s overdue and I need a letter from you to help my appeal. How can I work with these knees? I need them X-rayed. And you need to do something about my weight. And while you’re doing the prescription, you can put on some nicotine patches,’ she pauses for breath, ‘And you can do me a rehousing letter. I need a ground-floor flat coz for some reason they’ve put me on the second floor and the lift never works.’

I take a step back mentally if not physically, though the latter’s tempting. This, I reckon, could be fun.

‘I think I can see the overall problem here,’ I say, ‘You’re suffering from a chronic sense of entitlement.’ She narrows here eyes, but I plough on, ‘You’re confusing wants with needs, and because no-one has ever explained the difference, you’ve developed a learned helplessness and dependency which you’re locked into. I suspect no one has ever had the time or inclination to liberate you, but that’s what I’m going to do. Your freedom lies in one word, and that word is, “No”. So that’s what I’m saying. No. To everything.’

I sit back and wait for the fallout. The fact that I’ve folded my arms really isn’t a sign of smug self-satisfaction. It’s actually self-protection. So’s the tin hat.

She leans forward, looks me in the eyes, and begins: ‘I think I can see what you mean, doctor. You’re saying that over the years, I have developed the attitude, perhaps reinforced by health professionals, that I’m entitled to anything and everything. In turn,’ she continues, ‘This has undermined any vestigial ability or inclination I might have had to sort out my own problems, with the result that I’ve developed this unrealistic level of expectation and intractable passivity. The fact that everyone has bowed to my demands has simply, in the long term, led to my own disempowerment. I’ve become a victim of those who have tried to help me, because they have effectively rendered me helpless. So I understand why you’re saying “no”. Indeed, I appreciate the irony that your refusal is, after all, simply a reflection of your own entitlement, as a responsible professional, to tell what you see as the truth. I respect the stand you’re taking and will try to move on from here. I bid you good day.’

With that, she got up to leave.

Hand on doorknob, she turns and asks, ‘Any chance of a prescription for Calpol?’

‘Sure,’ I say.

Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield

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Readers' comments (28)

  • Excellent!

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  • Indeed, I appreciate the irony that your refusal is, after all, simply a reflection of your own entitlement, last two words should be in capitals.

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  • Now she 'll turn up at my pharmacy wanting everything that's on the minor ailments scheme. Oh that I had the silver tongue of Copperfield.

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  • Ildiko Spelt

    everyday i have a few of identical situations... (Clacton on Sea)

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  • genius :)

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  • Sadly so, so true.Unless the politicos have the courage to tell voters that the NHS is for their needs not their wants,this sort of nonsense will proliferate."Save our NHS:padlock the fridge!".....

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  • I'm delighted to help these sort of patients - it's much easier when you know they'll be paying a 40$ fee at the accounts desk on the way out,,,,,

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  • Thank you. This really lifted my spirits.
    As a professional working in substance misuse, mental health and criminal justice this is a regular presenting 'condition' of our client base. What happened to PHE's mantra of taking responsibility for oneself? Seriously though unless we all take a firm stance these clients will just turn up somewhere else.

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  • Absoulte genius!

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  • Ah the old Delusional Entitlement disorder or DED. It thrives in Surrey as well where parents aren't responsible for how their children turn out it is because we didn't diagnose the latent ADHD Dyslexia oppositional defiant disorder or Autistic spectrum in time to make a difference to their exam results!
    If only the nanny had a PhD things would have been so different!

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From: Copperfield

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