To relieve the all-pervading doom and gloom, and because it’s Christmas, nearly, I’m going to give you five sh**-hot tips on managing all those URTIs that are cluttering up your surgeries. I realise that clinical advice isn’t something you normally expect from this blog, and that you probably have your own perfectly satisfactory techniques for dealing with viral sniffles. But I have been in practice for 27 years now, so I’m really confident about recognising a cold when I see one. Plus my tendency to indulge punters with this type of complaint has, uh, hardened over the years. So here goes.
1. Be sure to interrupt any patients, and there are many, who utter the phrase, ‘I know it’s just a cold, but –’, with the words, ‘Get out, now’. Whatever follows the ‘but’ – ‘I’m going on holiday’, ‘It’s keeping me awake’, ‘It’s been going on for too long’ – will not bend the laws of science. So there’s simply no point in them finishing the sentence.
2. Remind them that the average cold takes about three weeks to resolve, and given that this is an average, it may well take a bit longer, so explain that they are not allowed to reattend within, say, six weeks. Also tell them that the typical individual suffers about four colds per year, ie is annually snuffly for around three months. And that, if they’ve been lucky enough to have only the one cold this year, it stands to reason that it will use up their entire annual catarrhal allowance in one go and therefore take 12 weeks to clear. This isn’t true but should be, and in my experience is something they will actually believe if explained forcibly enough.
3. Bringing to the GP, and insisting on showing, the vile phlegm-filled contents of a hanky is an act of aggression. Immediately remove the patient from your list under the ‘Violent patient’ scheme.
4. Exploit the mystical power of your pulse oximeter. Patients place massive faith in gadgets, certainly more than they place in me. I noticed this flu season that one patient seemed more than satisfied with my comment that his sats were 98% and seemed willing to sod-off antibiotic free without me doing anything further such as asking him lots of tedious questions or faffing around listening to his chest. I have used this short-cut technique with my oximeter ever since, thus: ‘My hi-tech illness-ometer confirms that this is a cold, your lungs are healthy, you don’t need any antibiotics and it’s telling me… hang on, it’s just updating… yes, that you can go. Now.’
5. If, despite all the above, they insist on antibiotics, laugh long and hard in their face for exactly one minute and then stop suddenly and just stare at them. After a while, they will go.
It almost makes you look forward to your next URTI, doesn’t it? You won’t have to wait long.
Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield
