The Great God of General Practice – actually, make that the Evil Satan – decrees that the following type of consultation shall only happen on a Monday morning, preferably as first appointment. Hence this starter-for-ten cracks of my own skull against the nearest available wall today.
‘The doctor at the hospital told me I was to see you to arrange a mammogram.’ This from a 78-year-old lady who had attended A&E over the weekend with an obviously musculoskeletal pain in her chest and a good deal of anxiety about a family history of breast cancer – an angst she clearly transmitted to our hero in the casualty department.
So, let’s see…she’s been told she needs a screening test, which is generally applied to asymptomatic women, for a symptom, chest pain, which isn’t a symptom of the thing she’s worried about, which is breast cancer, which she clearly doesn’t have. And the person whose responsibility it is to order this wrong test for this wrong symptom is, of course, me.
And the fact that I’m a GP with wrinkles borne of 25 years experience whereas he’s basically a white coated zygote counts for sod all, because a) He was in hospital, where all the real medicine takes place and b) He had a stethoscope draped around his neck and so clearly knew what he was talking about.
Deep joy. It takes ten minutes to unravel this little lot and start to have anything like a functional consultation. Ten minutes from a ten minute consultation. And rather more than that from my life expectancy.
Dr Tony Copperfield is a GP in Essex. You can email him at firstname.lastname@example.org and follow him on Twitter @DocCopperfield.