Yeah, I know exactly what you are like
Of all the phrases that patients use to rub saline into the wounds of us poor frontline GPs staggering our way through the primary care battleground, and God knows there are a few, I would like to nominate as the very worst, the following: ‘I know I should have come sooner, doctor, but you know what I’m like’.
This is absolutely always in reference to a symptom that not only should not have been presented sooner, but had no need to be presented at all. And in a patient who, yes, I do know what they’re like, and what they’re like is someone who attends repeatedly and unnecessarily and who spouts such self-martyring, self-justifying bollocks that consulting with them is not unlike having a red-hot poker repeatedly rammed up your rectum (I’m guessing here, obviously).
What I do know, GMC, look away now, is that it makes me want to punch them in the face
I’ve heard this phrase from patients countless times, yet I am still unable to work out whether:
1. They have absolutely no insight whatsoever and genuinely believe what they say.
2. They have total insight and are using this phrase as a kind of reverse psychology defence mechanism to protect themselves from the embarrassment that, here they are again, in a totally unnecessary consultation.
What I do know (GMC, look away now) is that it makes me want to punch them in the face. And for that, I feel deeply ashamed. On the other hand, this might represent the type of communication these patients genuinely understand, and could therefore alter future illness behaviour in a way that benefits everyone. So, patient, I should have done this sooner, but you know what I’m like….
Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield or follow him on Twitter @doccopperfield