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The writing’s on the wall

The writing’s on the wall

While clearly horrible and distressing, the abusive graffiti – ‘Doctors here don’t give a shit’ – sprayed on a surgery wall is something we should keep an open mind about. After all, we know that things aren’t always what they seem: in the same way that a shadow on a CXR may turn out not to be a malignancy, the defacing of a perfectly nice wall may not have malign intent, or at least may have mitigating circumstances.

So we should look beyond the message. For example:

  • Just as ‘Clap for the NHS’ was an awkward over-reaction, fuelled by hope and gorgeous weather, perhaps this, in the context of gloomy Covid news, dark evenings and drizzle, is simply the pendulum swinging the other way – the autumnal yang to the spring ying. In which case, we’ll all be nervously checking our surgery walls at eight o’clock every Thursday evening.
  • The ongoing suspension of the Friends and Family Test has blocked a significant conduit of feedback. So how else are the disaffected and disenfranchised expected to provide constructive criticism, other than via a spray-can and a convenient wall?
  • Perhaps we should realign our view of what patients actually think of us – something I did years ago when I asked a serially disgruntled punter why she still came to see me and she said, ‘Because you’re a bit less shit than the rest’. So, personally, I’d append to the graffiti, ‘…but some give slightly more of a shit than others’.
  • Whisper it quietly, but is it possible that this wasn’t written by unhappy patients at all? Study the picture closely. The giveaways are that the spelling is impeccable and there is no tell-tale unnecessary apostrophe in ‘doctors’. Could it be some kind of reverse psychology ploy? After all, as a mission statement to reduce workload, it’s very effective. And if you think that’s far-fetched, I’d point out that, when ‘F**k you nobhead’ was sprayed on our surgery door, there were as many staff believed I had done it to vent my anger to patients as believed the opposite.

Of course, I don’t want to make light of a serious matter. But you have to laugh, etc. Besides, like all apparently unjust feedback, it may contain a grain of truth for us all. It’s possible that we’ve vastly underestimated the therapeutic benefit of F2F and that the new era of remote consulting has left even the most undemanding patients feeling short-changed – and their opposite polarity positively venomous.

Patients will have to get used to our new way of working. And we may have to get used to the brickbats while they do. Because it’s pretty clear that the writing’s on the wall for the GP consultation.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at



Please note, only GPs are permitted to add comments to articles

James Cuthbertson 27 October, 2020 3:17 pm

Pure class- well done Copperfield

John Graham Munro 27 October, 2020 9:12 pm


Vardan Tadevosyan 27 October, 2020 10:23 pm

Not as shit as the rest of them… That’s what we should all aspire to- within the description of PCN DES or some other brilliant invention

Michael Mullineux 28 October, 2020 11:42 am

Great balancing view TC. The hyperbole and over-reaction from some to what is essentially an antisocial act of vandalism was crying out for some cynicism and realism. Thankfully most of our patients wouldn’t resort to spray painting walls or putting a brick through the window (as occurred recently to a local practice) to express their disaffection but in a way this form of ‘expression’ is almost easier to deal with than longwinded spurious complaints procedures we are forced to follow. The reality is that general practice and the NHS probably is a bit ‘shitter’ than usual at present from the punters point of view. Alea iacta est.

Patrick Flynn 28 October, 2020 1:20 pm

Thoroughly enjoyable commentary.

Douglas Callow 28 October, 2020 1:38 pm

Nice one Copperfield !
There is no doubt the grumbling and low level discontent makes life harder for our teams
Demand and expectations are ramping up just as C19 starts to make life trickier
The 2′ care ‘dumper-doo’ is adding to the challenge
Just hope the chancellor doesn’t add to pension misery by looking to tax lump sums as a way of paying down the huge debt HMG are happily signing us all up to
That bothers me far more than graffiti..

Sujoy Biswas 29 October, 2020 10:53 pm

Spot on. Well put and all that.
I have to say I kind of feel sympathy with the angst — I see patients locked outside frenetically pushing a buzzer in the pouring rain while the waiting room inside is empty. They are locked out whatever the glitterati say.

Patrufini Duffy 30 October, 2020 11:09 pm

It’s understandable. Probably they miss the free water dispenser, free condoms, free TV, free magazines and free time-wasting opportunity. You clearly don’t need a doctor if you can spray multi-coloured volatile gases eloquently on a large vertical surface. That tells me your respiratory, musculoskeletal and cerebellar systems are intact. Maybe not your heart though.

Dave Haddock 2 November, 2020 12:49 pm

Curiously this sort of behaviour does not seem to happen in private practice; perhaps time to escape the ghastly NHS?