A new patient. A clean screen. No medical history. No notes, and no hope of getting any for anything up to three months, despite the fact that she has moved from a practice only five miles away. Still, no biggie.
‘Good morning doctor. I’m hoping you’ll give me another prescription for my anti-depressant drugs. You see, nine months ago I suffered a traumatic relationship breakdown and my previous GP, Dr X of Practice Y, gave me 20mg of fluoxetine daily. Unfortunately that didn’t seem to help, so after eight weeks we changed to citalopram 20mg and then, after a further six weeks, 40mg daily. I’ve been taking that for four months now. I’d appreciate another prescription, I’m certainly feeling better, and I’m hoping to come off this medication in the new year.’
Seasoned campaigners will have recognised that last paragraph as total wish-fulfilment fantasy gibberish. It goes without saying that none of us has ever heard anything remotely that coherent from a punter.
Back in the real world, I hear this: ‘I want me nerve tablets and me sleepers.’ She says this without quite closing her mouth at any point. The plosive consonants are implied. I hide a sigh by pretending to have some sort of involuntary muscular spasm. ‘Which nerve tablets would these be then?’
‘I dunno, you’re the doctor.’ This seems to be pretty much the only fact that she has a handle on. I’ll spare you the painful details of the subsequent discussion, but suffice it to say that I enquired about the medication, the dosage, the reason for the medication, the duration of treatment, the existence or otherwise of a repeat prescription form, the identity of her previous doctor, the practice that he or she (the patient was not even clear about the gender) might have worked in, her medical history and, in eventual desperation, which building she currently considered herself to be inside, and to whom she was under the impression that she was talking at this exact point in time.
She had no idea about any of it.
By the end of the consultation, I had gleaned her name, address and date of birth – although I wouldn’t even trust that last bit – and the fact she had been on some drug or other, possibly a psychoactive one, for a period of anywhere between a month and 20 years.
I passed it on to my wonderful, long-suffering front-office staff, who will now spend anything up to an entire afternoon phoning practices at random to fill in the gaps.
This is not unusual. My point is, where has our collective shame gone about being utterly ignorant about everything, including things you might expect were vital to our daily existence? If I had by some chance forgotten my middle name, I’d blush to my very roots and apologise. But in the course of my work, I meet growing numbers of utter berks who have not bothered to assimilate their own phone numbers or shoe sizes, and who appear to expect others to point them in the right direction when they want to go home. They take no responsibility for any of it. And they’re not embarrassed at all.
Dr Phil Peverley is a GP in Sunderland
