Sad and confrontational patients are a key source of stress for GPs – it’s official. Which is quite helpful if you’ve always wondered why, when you finish Monday morning surgery, you feel like punching in the face the next person who says anything other than ‘here’s your tea and biscuits’.
Our problem is, of course, that we’ve never had the time, resources or self-indulgence to deal with the daily stress shit-storm of standard general practice.
Others do. I never tire of chortling over the fact that counsellors are regularly debriefed, and so are their debriefers, and so on, all the way up a touchy feely pyramid topped presumably by a fluff-filled deity.
And I also remember the time when the tutor for our mandatory child protection training, after a piece of supposedly harrowing role-play, told us that we should take some time out ‘to get our heads together after that’.
We’ve never had the time, resources or self-indulgence to deal with the daily stress shit-storm of standard general practice
I felt like telling her we deal with these problems, and worse, every ten sodding minutes every sodding day and that if I actually had any opportunity to take time out then it would be to disimpact my overloaded colon. So I did (tell her, not disimpact).
Anyway, out of necessity, I have developed my own very special technique for dealing with patients suffering sadness. It’s pretty simple. If I sense the consultation is heading that way (snapping my pen is a good sign) then I allow them to pursue their litany of woe for about 90 seconds, and then I say: ‘Well, this sounds like an absolutely fascinating story about your empty life/work stress/relationship difficulty/housing problems/financial worry/deceased dog etc, but I’m just wondering how, as a doctor, you thought I might be able to help?’
I realise, for any trainees reading, that this is a CSA auto-fail, as you’re actively encouraged to take into account psychosocial issues. But I’d also actively encourage you to take into account that, after nearly 30 years, you start to realise you can’t do much about them. Besides, cutting to the chase spares you another 8.5 minutes of your soul being destroyed.
But what about the confrontation when you decline that antidepressant, housing letter, sick note or whatever? Well, rather confrontation than collusion. And a big fight can be quite a stress buster. Even if it does leave a mess on the carpet.
Dr Tony Copperfield is a GP in Essex
