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At the heart of general practice since 1960

I’m sorry, I haven’t a clue

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A new patient. A clean screen. No medical history. No notes, and no hope of getting any for anything up to three months, despite the fact that she has moved from a practice only five miles away. Still, no biggie.

‘Good morning doctor. I’m hoping you’ll give me another prescription for my anti-depressant drugs. You see, nine months ago I suffered a traumatic relationship breakdown and my previous GP, Dr X of Practice Y, gave me 20mg of fluoxetine daily. Unfortunately that didn’t seem to help, so after eight weeks we changed to citalopram 20mg and then, after a further six weeks, 40mg daily. I’ve been taking that for four months now. I’d appreciate another prescription, I’m certainly feeling better, and I’m hoping to come off this medication in the new year.’

Seasoned campaigners will have recognised that last paragraph as total wish-fulfilment fantasy gibberish. It goes without saying that none of us has ever heard anything remotely that coherent from a punter.

Back in the real world, I hear this: ‘I want me nerve tablets and me sleepers.’ She says this without quite closing her mouth at any point. The plosive consonants are implied. I hide a sigh by pretending to have some sort of involuntary muscular spasm. ‘Which nerve tablets would these be then?’

‘I dunno, you’re the doctor.’ This seems to be pretty much the only fact that she has a handle on. I’ll spare you the painful details of the subsequent discussion, but suffice it to say that I enquired about the medication, the dosage, the reason for the medication, the duration of treatment, the existence or otherwise of a repeat prescription form, the identity of her previous doctor, the practice that he or she (the patient was not even clear about the gender) might have worked in, her medical history and, in eventual desperation, which building she currently considered herself to be inside, and to whom she was under the impression that she was talking at this exact point in time.

She had no idea about any of it.

By the end of the consultation, I had gleaned her name, address and date of birth – although I wouldn’t even trust that last bit – and the fact she had been on some drug or other, possibly a psychoactive one, for a period of anywhere between a month and 20 years.

I passed it on to my wonderful, long-suffering front-office staff, who will now spend anything up to an entire afternoon phoning practices at random to fill in the gaps.

This is not unusual. My point is, where has our collective shame gone about being utterly ignorant about everything, including things you might expect were vital to our daily existence? If I had by some chance forgotten my middle name, I’d blush to my very roots and apologise. But in the course of my work, I meet growing numbers of utter berks who have not bothered to assimilate their own phone numbers or shoe sizes, and who appear to expect others to point them in the right direction when they want to go home. They take no responsibility for any of it. And they’re not embarrassed at all.

Dr Phil Peverley is a GP in Sunderland

Readers' comments (19)

  • If she was that coherent she wouldn't have a mental illness - would she. You're egging the pudding a bit on this one.

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  • Dr Peverely obviously hasn't immersed his addled brain in any psychological medicine. As you see others so you see yourself.

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  • Phoning practices at random? Why would they do that when a quick call to your local FHS organisation was all that was needed? They would be able to confirm the previous practice and also put in an urgent request for the records. Better get in quick whilst they still exist though.

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  • Oh dear - pity it isn't a 'perfect' world filled with 'perfect' people... gee whiz - I think I've seen it all now.... folk come in all different shapes and sizes. All it takes is a long appointment for review at a later time and a phone call to (in Scotland at least) - Practitioner Services.

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  • Wow!
    You are all so perfect (and smug)!
    I recognize this consultation-and it is both unbelievable and astonishingly annoying!!
    Beautifully and humourously described-keep up the good work!

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  • Are some of us missing the point of the article here?

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  • Intrigued as to what this poor women's previous GP looked like, if she can't say whether they were male or female.

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  • She more than likely didn't have A Doctor....people can see anything up to one of 8 different GPs over a short time in some places...one reason why 'she' is still so unwell perhaps

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  • Ha ha people really don't "get" your column do they Phil? I find the numpty comments as funny as the column itself sometimes.

    Keep it up!

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  • Charge them by the minute and it would be amazing how much they remembered!

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