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1250: A difficult decision

It's lunchtime at the Jobbing Doctor's practice, and a patient has just asked for a crucial piece of advice.

So, morning surgery finishes at noon, just before I need to call it morning and afternoon surgery. It has been a fairly typical session, and the most challenging consultation was a patient who has come to see me to ask if he should have surgery, as recommended by the consultant.

Time was when I would never dare to gainsay what a consultant would suggest, but these days the quality of the consultants is so variable, and the advice and management tend to be very scientifically-based, and hospital doctors often ignore the bigger picture.

Recent experience has shown me that people genuinely want the opinions of Jobbing Doctors, and if I say ‘have the operation', they will; if I say ‘don't have the operation', they won't. That places a huge onus on my assessment of risks and benefits, and does not sit comfortably with me.

Today's consultation has been complicated by the fact that I do not have the recent outpatient letter, so I am not advising them on the most up-to-date facts.

I have given a preliminary view (don't) but will need to see more information.

Time will tell.

Jobbing Doctor