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The four horsemen of the GP apocalypse

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The day started with a visit from angry shouty man. For once though, he wasn’t waging war with me.

He was furious with the DWP for cutting his benefits, enraged that the hospital had postponed his operation and indignant that the council should dare turn down his application for alternative housing.

This patient is not merely angry though, he’s entitled angry - nothing is his fault and the world owes him everything. Being at the lower end of middle age and to my knowledge not having done a day’s work for over a decade, he beautifully personifies my ‘loud and shouty, inverse tax paying rule’ - the louder someone shouts about having paid their taxes, the less they have actually contributed.

A little later on and I was visited by an anorexic patient. Half a lifetime of counselling and psychiatrists’ input have made little impact on this patient’s issues. 

Finally the morning was topped off by a small child with a cold brought in as an urgent extra. The mum had brought her in three times in the last two weeks already and on each occasion had been told her child had  a common cold and was advised on symptomatic treatment. A wise general will pick his battles and I knew I’d lost this one before she’d sat down. It was a simple choice; antibiotics or a long argument with mum. I acquiesced and accepted I was beaten.

It was not until late afternoon that some ancient remnant of a long forgotten school RE lesson wormed its way into my consciousness. Was I remembering that story about the four horsemen of the apocalypse correctly: war, famine, conquest and death?

I checked the computer, no patient deaths this week. I was imagining it all.

Then, like a left hook from a drunk in A&E, it hit me - the CQC are coming next week.

Dr David Turner is a GP in west London

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