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At the heart of general practice since 1960

Your first... doctor as patient

Dr Stefan Cembrowicz advises how to treat this unique group of patients

Dr Stefan Cembrowicz advises how to treat this unique group of patients

Doctors are an at-risk group. We have jobs bathed in other people's stress, and we toil to operate the creaking machinery of the NHS in our patients' interests. We have easy access to medication that is forbidden to the public. Our training has taught us to ignore personal discomfort, and eating, sleeping and self-care takes second place.

How doctor-patients feel

It is a privilege to be asked to treat another doctor. But your doctor-patient may have ignored serious symptoms, self-medicated inappropriately, or be focusing great anxiety onto half-remembered diseases. They may be nihilistic or overanxious about health, and may refer themselves to secondary care or take corridor advice from colleagues without giving them the chance to make a whole-person diagnosis.

What you should do

Do it by the book when seeing a doctor. Check their health parameters properly. Carry out formal examinations (digital rectal examination, smear, swabs) even when you feel you needn't bother or you feel embarrassed. Keep proper records; see they are happy with them. Think physical-psychological-social just as you would with any other patient. We doctors are human too: and subject to the same woes and weaknesses as our patients.

Ask about alcohol consumption and non-prescribed medication – official or otherwise. Put your colleague at ease by phoning to avoid queues, bypassing waiting times and smoothing out the little annoyances that we all expect on the road through our NHS. Health staff are officially given priority by the NHS and we need it. Avoid being intimidated or drawn into unhealthy work cultures; one consultant phoned me to ask why his houseman was off sick as the firm was feeling the strain without her. This was none of his business.

Keeping doctors healthy

GPs now have access to occupational health services that help make the job fit the worker rather than vice versa. We may regard illness and death as day-to-day occurrences, and when it is our turn to become unwell we may regard this as impertinence, or go into denial – just like our patients, as we are merely human. Some of us continue working when we should not, and cling to the very routines that are too much for us. Should you come across this situation you have to consider the patients' welfare too. Doctors should not be at work if they are stressed or unwell.

If you are concerned that patients may be put at risk by a doctor's ill-health, and cannot resolve matters by giving clear advice to the doctor concerned, take careful advice from a more experienced partner or LMC member.Most of the time your doctor-patients will not exhibit the above woeful pathologies, and demonstrating your best consultation skills to them will be a pleasure.

Dr Stefan Cembrowicz is a GP in Bristol

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