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If our diagnostic skills become obsolete, I’ll eat my hoverboard



‘Apparently, the other day, Jeremy Hunt said…’

This is a phrase guaranteed a) To get you reading and b) To make you angry.

And I don’t think you’ll be disappointed on this occasion. Because, apparently, the other day, Jeremy Hunt said that gizmos being developed by ‘technology gurus in California’ will render GPs’ diagnostic skills obsolete in 20 years’ time.

It was a throwaway comment, to be fair. Then again, why would I want to be fair to Jeremy Hunt? Besides, the unspun remark is often the most revealing.

Much of the time, don’t make diagnoses. We make non-diagnoses.

And this does reveal something, doesn’t it? It reveals a profound ignorance of general practice, which won’t surprise you, but is nonetheless surprising in the Secretary of State for Health.

What Jezza doesn’t seem to realise is that GPs, much of the time, don’t make diagnoses. We make non-diagnoses. Many symptoms are impossible to explain with certainty, but that doesn’t matter, because patients often want to know what isn’t wrong more than what is. They want to know that their headache isn’t a brain tumour, that their numbness isn’t MS, that their rash isn’t meningitis. Being able to reassure in an accurate, effective and authoritative way is an incredibly valuable service, as it saves patients time, appointments, investigations and anxiety, and it saves the NHS queues, money and incidentalomas.

Mr Hunt doesn’t value this at all, because he’s oblivious to it. Just like he’s oblivious to how we deal with multiple symptoms, take an overview, live with uncertainty, contextualise, hypothesise, multitask, health-promote and so on. In ten minutes. Stick those in your fancy diagnosticator machine and see what happens.

But that’s clearly how he thinks he can replace us in the long term. And in the short term, of course, he thinks our job can be done by protocol-driven parapharmasician-associates.

So that’s what he thinks. Maybe it’s time we should tell him what we think. Which is that frankly, Jezza, you haven’t a friggin’ clue about general practice.

And if, in 20 years time, I am replaced by a piece of Californian technology, I shall eat my hover-board.

Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield