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GPs go forth

Hark, for I have witnessed the holy grail of GP correspondence


Sit down. Take a deep breath. And suspend credulity. Because I have some big news. Bigger even than the current hot potatoes about medical indemnity, GPs going private, mass list closure and so on. News that really does represent something of a miracle. And, like many miracles, it occurred on an ordinary day, in a nondescript place, during mundane activity.

Specifically, it happened in my surgery as I was ploughing through the day’s mail. This is usually about as far from a spiritual experience as you can get, evoking feelings which, if I was sitting on the other side of the desk, would have the GP speed-dialling the Mental Health Crisis team.

Yet there it was. Sitting in front of me: a discharge letter from the local hospital about an elderly patient who had been admitted with falls, who had been diagnosed with a ‘UTI’ and who had been discharged on loads of drugs. Yes, I know, I’m drifting into a coma, too, even as I write these words.

And yet. Something leapt out from that discharge letter. Something that hit me in the face with a force so physical that I actually emitted a strange cry somewhere between fear, incredulity and joy. It was a simple sentence, but it was also an epiphany.

This is what is said: ‘GP action: there is no GP action required for this patient.’

I re-read this several times. I tested my visual acuity on the Snellen chart. I slapped myself in the face to make sure I was awake. But even as my eyes watered with pain and emotion, the words remained: ‘THERE IS NO GP ACTION REQUIRED FOR THIS PATIENT.’

I ran, wielding the letter, into our common room, interrupting the usual caffeinated post-surgery catharsis. Soon, my colleagues were clamouring around the letter, some laughing, some weeping, all sharing my joyous disbelief.

For here, for the first time, was a patient for whom I was not obliged to chase up an MSU, repeat the electrolytes, arrange an appointment for memory assessment, send to the falls clinic, repeat a scan to monitor a renal cyst, kindly refer under the two week rule for a lung opacity or organise domiciliary chiropody. I was, instead, expected to do nothing. At last: I was liberated.

Cynics among you may view this blog as a complete fabrication. I understand. There will always be disbelievers, and it is an incredible story. All I can say is that there is now a corner of my surgery which I will always view as holy. And it does look like a shrine, with that framed discharge letter, the candles, the flowers – and the GPs who come from far away to witness it for themselves, entering as burned out shells and leaving as bright-eyed doctors on a primary care mission.

Admittedly, it was disappointing to get a revised discharge letter two days later asking me to sort out the patient’s ear wax. So I’ve just hidden that in a drawer.

Dr Tony Copperfield is a jobbing GP in Essex



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Readers' comments (10)

  • As mythical as a 'Flat Earth'....

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  • Copperfield has finally lost it and is in a world of his own delusion.

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  • Sorry Tony you did not read the letter properly, you did not notice that they have stopped her aspirin and started ramipril. There is no mention of reason for these changes. she previously had MI.Are you going to make these changes in her record or contact the discharging team about why these changes and you have to monitor UE in 2 weeks anyway as ramipril been started.

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  • Brilliant as always. Looks like most GPs could not believe it too. I once had a letter only once I would add from the cardiologist that says GP action :none. How sensible a discharge letter. There is still a tiny bit of hope.

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  • National Hopeless Service

    Fakenews Copperfield.

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  • I can beat that. I had a letter from an orthopaedic surgeon today that said, "I think this patient should see a rheumatologist before we consider surgery AND I HAVE TAKEN THE LIBERTY OF ASKING ONE OF MY RHEUMATOLOGY COLLEAGUES TO SEND AN APPOINTMENT."

    But yes, usually I'm like, "Monitor serum rhubarb? WTAF? And you DO know that GPs are clever and can treat THAT and THAT and THAT without tests and referrals, don't you?"

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  • Tony I think you are going to find that this is all just a dream your wife had whilst you were in the shower.

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  • Made me snort out loud with laughter! Thank You.

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  • I had a patient see me today to discuss a comment on his cardiology discharge letter following a fast AF admission - GP to refer to endocrinologist regarding sub clinical hypothyroidism - didn’t know whether to laugh or cry!

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  • Just fab. So funny.what a great writer.

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