Over the years, medicine has given me a lot, particularly migraine and a duodenal ulcer. It’s time to give something back. So, as a service to GPs, I’ve written some letter pro formas which you can photocopy and adapt as you see fit. I know you’ll find them useful.
1 To the lower limb practitioner
Dear lower limb practitioner, whatever that is, thank you for asking me to arrange an MRI scan on this man’s back.
Unfortunately, I do not have direct access to MRIs. That’s why I actually sent him to an orthopaedic surgeon. So this patient has been diverted by the referral management centre away from the person who can arrange what he needs to someone who can’t and whose solution is to send him back to someone else who never could. Have you read Kafka? Love, Dr C.
2 To the FY2 doctor
Dear FY2 doctor, thanks for your kind ‘GP to-do’ list on my patient’s recent discharge letter. Now I no longer have to worry about how I’m going to spend my morning. While I’m repeating U&Es, monitoring blood pressure, titrating ACE inhibitors, arranging renal OPA and sorting out his hearing aid, may I suggest, ‘FY2 to attend health centre, see 18 patients, do eight telephone consultations and six visits, and clean the windows?’ Yours co-operatively, Dr C.
3 To the FY1 doctor
Dear FY1 doctor, no, I will not ‘chase up this patient’s MSU’. I’ve never heard anything so preposterous in all my life. Go boil your head. Kind regards, Dr C.
4 To the complementary practitioner
Dear complementary practitioner, thank you for asking me to confirm that Mr X is fit to have Hopi candle wax therapy.
In my opinion, anyone paying to have lit candles stuck in their ears is either retarded or mentally ill and therefore lacks capacity. Yours, Dr C. (P.S. I should point out that, to be honest, complementary therapists quite literally make me want to puke my guts up.)
5 To the optician
Dear optician, how about you invest in a sphyg and a cholesterol monitor so that you can prove to yourself that whatever you keep seeing in people’s retinas is not actually hypertension or hypercholesterolaemia? Love, Dr C.
6 To the gym
Dear gym, current medicolegal advice is that we couch ‘Fitness to exercise’ forms in a double negative. You can’t be too careful, though, so I’m doubling that again. So I can confirm that I’m unaware of not knowing any reason why Mr Y shouldn’t avoid exercise. Yours not insincerely, Dr C.
7 To the pharmacist
Dear pharmacist, thank you for the MUR you sent for my patient with IHD who’s taking a statin. You’ve suggested I check his cholesterol. So that’s what they’re for! I’d always wondered. Yours enlightenedly, Dr C. (P.S. How do I do that, exactly?)
8 To the consultant
Dear consultant’s secretary, thank you for returning my referral letter, but, no, I will not complete the ‘correct’ referral pro forma, because there is nothing in my contract which requires me to do so.
Any delay experienced by my patient – and therefore any harm, and its potentially enormous medicolegal ramifications – will be entirely your responsibility. Sleep well, Dr C.
9 To the person who takes offence
Dear whoever, I’m sorry my standard reply caused such offence. Oh, hang on, no I’m not. That was the idea. Sod off, Dr C.
Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield
