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Sometimes a punch in the face is the only solution


Dr David Turner


Yes, I found this rather disturbing also, but I was informed that the conclusion to a seminar about bullying for secondary school children ended with the instructor advising that when every other tactic has failed to deal with a tormentor, a punch in the face may be the only option left.

I hate bullies. I mean, really detest them. A psychiatrist I once worked with told me that it’s important to be aware of the personality types that irritate you most. For him, it was narcissists, for me, bullies.

I think general practice has been the victim of too many different bullies for way too long. The CQC, GMC, NHSE, DHSC, and, I’m sad to say, secondary care, have all in their time taken their turn in giving us a dead arm and stealing our sweets in the corner of the playground and, like a rather pathetic victim, all we do is hand over the candy and whimper meekly while waiting for the next beating.

When will we as a profession, and particularly those who call themselves our leaders, realise that the softer options of negotiation, reasoning, pleading and logic are strategies that will never work with a bully? No, it is time to hit the nuclear button.

We must remember that bullies are such because fundamentally they’re insecure. Using threats and belittling others is their way of hiding their own inadequacies. I’ll leave it you to work out which of the aforementioned bodies this applies most to.

Now, when I say a punch in the face, of course I don’t literally mean giving the current health secretary a bloody nose. Although I can think of plenty of them in my career I’d have paid good money to bop on the hooter. No, of course I mean a metaphorical punch in the face. In the case of general practice, this means saying: no. Saying: no, no, no and no again, and for once actually meaning it.

No, we will not take part in your pointless appraisals and revalidations. No, we will not move every item that makes our consulting rooms habitable just because of the tiniest risk that it may harbour bacteria. No, we will not engage in more unpaid data collection for the Government. No, we will not act as secondary care skivvies. No, we will not be patronised in one breath and slated in the next.

So how about it? Is anybody else ready to glove up?

Dr David Turner is a GP in Hertfordshire

READERS' COMMENTS [8]

Simon Gilbert 24 November, 2021 8:28 am

Good ideas here but the current structures make it difficult to identify the bully. Referrals are rejected by non doctor clinicians; complaints by GPs are handled by, often ignorant and transitory, managers; under commissioning is endemic with no rapid recourse for the identifiable GPs left holding the resulting systemic risk; guidelines and regulations create standards inflation above commissioned care; courts, CQC and GMC blame individuals not wider systems for bad outcomes.

In such an environment how do you identify who to ‘punch’?

David Church 24 November, 2021 12:16 pm

To both David and Simon :
How about hiring a mercenary to deliver the punch, and let them decide who gets it while they are at it?
Again, being slightly metaphorical.
It is of course enjoined upon us GPs to be vcareful to not impose or express our own beliefs or politics upon the patients, but within that GMC guidance, we can make it quite clear to the patients that they cannot have the best treatment, or what they want, because the NHS does not allow it. Let the mercenary patients work out for themselves that the NHS is run by the Government, and that since they cannot vote on NHS Manager appointments, the obvious target is MPs at the next Elections !
Now of course, like D Turner, I am also in favour not of a punch on the actual MP’s nose, but advocating instead a far more effective punch to their ballot-count ! A nice round zero might be nice.

Patrufini Duffy 25 November, 2021 12:04 pm

No. I mean yes. I mean work smarter, not harder. And for goodness sake, get out of the PCN. Or stop complaining, when they come to get you. Penned in, comfortably for a life of 2022 monitoring.

Finola ONeill 26 November, 2021 2:55 pm

No to the PCN DES. No to any qof, admin, basically all non urgent clinical work until the funding allocated via the PCN and all the other streams is given without strings attached. A kind of work to rule if you will. No industrial action is needed at all. Simply a work to rule. Clinical work only until the two above provisions are met. We will have lots more time for face to face appts no? Even keep the daily mail readers happy.
oh and a no to data sharing. Its a medico legal minefield, of no benefit to patients and clearly just some more dodgy dealings by the opaque DHSC/NHSE/NHS Digital/Tory donor nebulous grouping.

Nick Mann 26 November, 2021 3:47 pm

With you all the way.

Malcolm Kendrick 27 November, 2021 9:15 am

Doctors are far to wedded to the role of Martyrdom. Not all, but too many to make it possible to get the profession to stand up to the bullies.

C Ovid 27 November, 2021 2:27 pm

Unfortunately we are divided. I describe myself as a pragmatist, ready to work to rule, so that our profession can rise up the priority list of gov’t attention or go private. I am outflanked by the cardigans who want to deliver blankets to the elderly on their day off and donate their income to Oxfam, and in the blue corner, those who feel we should take on every new income stream at whatever cost even if it loses money, to show we are “great little shopkeepers” (which we are not). God help us all.

C Ovid 27 November, 2021 2:29 pm

.. our GMC duty of candour is not being honoured. We can’t actually do either effectively any longer.