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Bounce-backs from the Baltics



For the avoidance of doubt, I am absolutely not a ranting xenophobic/racist/UKipper/whatever and anyone who thinks otherwise can sod off back where they came from. But the thing is, I have a learning need, and to explain it I might just come across as ranty, xenophobic etc.

So. I have a cohort of Eastern European patients. Most are absolutely fine and dandy, but a small minority consistently seem to value my opinions and management of their ailments about as much as they appreciate stepping on a fresh and steaming dog poo.

This may be a cultural thing, to do with the way their native healthcare systems work. Or maybe I really am just a crap GP. After all, to be honest, plenty of my non Eastern European patients also seem to rate my clinical acumen some way below Dr Google’s, or their next-door-neighbour’s. But the key difference seems to be that my dissatisfied Eastern European punters have a tendency to react by popping over to their own particular Eastern European country, having an unnecessary scan revealing lots of incidentalomas and then, on their return, dumping the report in my lap for me and the trusty NHS to sort out.

They do this with an expression so smug that it saves them actually having to articulate: ‘Told you so, now send me to a proper doctor.’

Now I think it through, though, my indigenous unhappy Essex patients actually do much the same thing. But they at least save on travel and accommodation by simply waltzing off to the local DGH where, these days, a whole body MRI is integrated into the ‘Welcome to A&E’ doorframe. The only saving grace is that, while the report that plops into my inbox for me to ‘do the needful’ is perplexing, ambiguous and confusing, it is, at least, not written in Lithuanian*. And it’s all very well for the BMA to advise us to be more robust about our bounce-backs, but that’s tricky when you’re trying to sell the concept to a Dr Vaitkevicius of Vilnius University Hospital**.

So you probably think my aforementioned learning need is something like, what should I do about asymptomatic renal cysts picked up on MRI, or how can I convincingly dissuade patients from unnecessary scans, or what can I do to stop hospital investigating indiscriminately? But it isn’t. My learning need is actually working out what ‘Šis pacientas turi nepaaiškintą bendrą tulžies latako išsiplėtimą, prašau, būtinai’ means.

*If you think I’m being Lithuaniaist, I refer you to my opening para. Please insert another Eastern European country of your choice.

**If this person exists, and you’re reading this, it’s not actually you, okay?

Dr Tony Copperfield is a jobbing GP in Essex