This site is intended for health professionals only

At the heart of general practice since 1960

pulse june2020 80x101px
Read the latest issue online

The waiting game

Life is the best education for a GP

Dr Zoe Norris

We all know that the quickest way to finish your annual appraisal is to tick all the boxes, complete your PDP and reflect sufficiently in the right places. Does it help us be a good GP? I’m not so sure.

But opportunities to learn are all around. Here’s a few of my own. Give yourself a point for each one you’ve done, and do feel free to suggest your own:

1 Sit up all night with a child who has acute otitis media until their ear drum perforates. It’s crap. No amount of analgesia helps, and while I know antibiotics won’t do anything in most cases, I will now be considerably more sympathetic when explaining this to parents. For bonus points, do it in a hotel room abroad.

2 Have at least two acute admissions: one that turns out to be nothing (trapped wind is a good one), and one that results in a hospital stay of at least 48 hours. The first one is because it is what all patients fear. The second one is because the helplessness of being unwell and away from home makes you realise that the smile and kindness of an HCA makes so much more difference than the cleverest imaging or consultant.

3 Try one dose of everything you prescribe. Now I realise there are some minor GMC issues with this, but when the opportunity arises, seize it. For instance, tramadol is proper nasty. Anything designed to replace food can be substituted with a slice of fruit cake and glass of full-fat milk for the same calories. Metronidazole/co-amoxiclav is worse than the original infection. The sugar-free flucloxacillin suspension tastes genuinely hideous – screw your kid’s teeth. For bonus points, eat hospital food for 48 hours. Anyone I admit now, I advise them to take snacks.

4 Have at least one unpleasant examination. A smear for ladies, prostate for men. Some form of endoscopy is enlightening too (lesson – always take the offered sedation). You will still refer patients for them, but with more compassion and some practical tips.

5 Breastfeed. And bottle feed. Preferably with a normal baby who doesn’t know how to do either, while you are horribly sleep deprived. I’m ignoring gender issues; you should damn well try it. Remember this when new parents come with what seems like a daft question.

6 Take a course of antibiotics without missing a dose. You can’t, can you? It’s impossible to remember them all. Now multiply that difficulty by 15 and look at the next 85-year-old you see. Time to de-prescribe.

7 Have headlice. And scabies. Then try to treat them. Lessons – prescribe a shedload more of the treatments than you think you need to, and expect lots of mess, towels, and weird smells.

8 Have constipation. And piles. Check what you are prescribing actually works – your patients will love you forever.

9 Ring NHS 111 with a straightforward problem. UTI is a good one. Then wait until common sense is overridden by protocols and you are blue-lighted to a tertiary centre.

10 Cope with losing a loved one. The vulnerability both personally and professionally. Learn that being a medic doesn’t prepare you for this. Nothing else reminds us of the difference a GP can make quite like needing one ourselves.

Dr Zoe Norris is a GP in Hull



Related images

  • dr zoe norris duo 1500x1000px


coronavirus john lewis vouchers 180x250px v2

Rate this article  (4.42 average user rating)

Click to rate

  • 1 star out of 5
  • 2 stars out of 5
  • 3 stars out of 5
  • 4 stars out of 5
  • 5 stars out of 5

0 out of 5 stars

Readers' comments (10)

  • Vinci Ho

    The philosopher Immanuel Kant said that rational human beings should be treated as an end in themselves and not as a means to something else. The fact that we are human has value in itself.

    Unsuitable or offensive? Report this comment

  • Good article Zoe.
    They can't measure experience, both professional or personal.
    Which shows the tick box philosophy for what it is.

    Unsuitable or offensive? Report this comment

  • 100% agree. A stoma, even for a few months is informative, as is having a relative admitted under the psychiatrists. One of the reasons older doctors are more sympathetic, more life experiences.

    Unsuitable or offensive? Report this comment

  • Cobblers

    Yes. I read each one thinking about my own times with children and being a patient. It changes you, I think for the better, as regards dealing with people and patients.

    5 stars from me.

    Unsuitable or offensive? Report this comment

  • thank you Zoe!
    reminds us of the true importance of what we are and what we do.
    you are great! keep it up!

    - anonymous salaried!

    Unsuitable or offensive? Report this comment

  • Vinci Ho

    When I had emergency left retinal detachment repair in 1995( sadly, the ophthalmic surgeon operating on me passed away a few years later), it took me by surprise how severe the postoperative pain was . Painkillers gave me really bad constipation.
    The word empathy is only meaningful if you had owned a real life experience(s),

    Unsuitable or offensive? Report this comment

  • Bob Hodges

    I'm going to get a T-Shirt printed that says:

    "Instant Lunatic - Just add Tramadol."

    I will also add that I get get told off for prescribing lots of Etoricoxib because it works so well for me, without destroying my stomach.

    Unsuitable or offensive? Report this comment

  • Spare us all from the doctor who believes that their personal experience of an illness gives them more than the most rudimentary insight into another human being's experience of the same illness.

    [Having said that, the one upside of my brief encounter with the black dog is that I now have a massive amount of respect for people who struggle on, day after day, with chronic anxiety and/or depression humming away in the background.]

    Unsuitable or offensive? Report this comment

  • doctordog.

    I think the opposite.
    If I have endured all these adversities without running whinging to the GP, and sustained no sequelae, I have less sympathy for those so afflicted.

    Unsuitable or offensive? Report this comment

  • Sorry Lorna , but I think that is being quite cynical.
    And I should know......

    Unsuitable or offensive? Report this comment

Have your say