Phil’s got to the root of why 20% of GP consultations are for self-limiting conditions
Apparently there’s no louder noise than the sound of a rivet being blasted through sheet metal a few inches from your head, and there’s no town in the UK that has built more ships than this one. So I’m used to the fact that a lot of my older male patients are profoundly and irritatingly deaf.
This can make negotiating with them on the phone a Sisyphean task. ‘IT’S ME LEGS DOCTAH! AH CANNAT WORK ME LEGS!’
‘How do you mean? Have you got any pain?’
‘IT’S ME LEGS!’
‘I know. What’s the matter with them?’
‘IT’S ME LEGS! ARE YE CUMMIN OOT?’
It was obvious that he could have been talking to the Speaking Clock as far as he was concerned, and he hadn’t heard a word I’d said, so I had to go out if only to let the MDU sleep easy in their beds. I checked the computer, and wonder of wonders, there was a fax from the hospital. It seems he had been discharged the day before after a long stay with pneumonia. So the consultation wouldn’t be entirely a game of Give Us A Clue.
In the event, like many of these old gadgeys who have been deaf for decades, he was a fair lip-reader face to face. In that respect, the encounter wasn’t as bad as I had been expecting. In every other respect, it was. He answered the door in his pyjamas and dressing gown. I immediately noticed he was standing up. There’s no flies on me.
‘I thought you’d lost the use of your legs!’
‘Oh, that was last night, doctah. They’re all right now.’
‘Well I got out of hospital yesterday afternoon. Last night I went down the ex-serviceman’s club like I always do, and when I was coming home, me legs were all over the place! I was as staggering as a bastard! I had to get a taxi.’
I experienced a glimmer of understanding. ‘Did you have a drink last night at all?’
‘Oh aye doctah, just me usual. Six pints.’
‘How long were you in hospital?’
‘I went in on New Year’s Eve.’
‘Did you have much beer while you were in hospital?’
‘Not a drop! It’s not a pub in there, you know!’
The mystery of the wobbly legs solved, I returned to the surgery deep in thought. This week, a report by the Self-Care Campaign (whatever that is) has stated that 50 million consultations every year are for ‘minor ailments’ and 20% of GP encounters are wasted on self-limiting conditions that don’t need medical input. ‘No shit, Sherlock,’ I can hear every GP muttering.
The recommendation is that all GPs and nurses should be trained in helping people treat themselves, in order to save the NHS £10bn over the next decade. I had thought, possibly naively, that we’d already been trained for that, that we were doing this, and had been since the NHS began. But most people are dafter than we are.
I took another ‘emergency’ call later that day. ‘It’s terrible! Every time I have a sip of tea, I get a sharp pain in my right eye!’
I counted to 10. ‘Have you tried taking the teaspoon out of the cup?’
Dr Phil Peverley is a GP in Sunderland