GPs’ bags are a fascinating reflection of changing working practice. My own shiny briefcase is of course sturdy enough to do double service as a chair, which I believe has been a common requirement of house visits for decades.
But whereas ten years ago it would have been full of pharma-branded stethoscopes and sphygs, tightened regulations mean that all my diagnostic toys are anonymous. And the bag’s black market value would have been higher a few years ago as well; there isn’t any morphine in there these days. The briefcase’s a fairly staid bit of doctor’s kit, in truth – but back at the surgery, things are a bit more imaginative.
My new favourite diagnostic tool is unfortunately too big to take out on the road. It’s a handsome red and yellow rocking-horse, which sits in one of the partner’s rooms, and which has earned an irreplaceable role in my assessment of under-fives.
If a worried Mum brings little Charlie in with an acute illness, and the first thing he does is run across the room and saddle up, we can all relax. I’ll go through the history with Mum, and of course I’ll examine Charlie when he’s finished cantering alongside my desk. But a positive rocking-horse sign is about the best indicator I’ve found for the lack of serious acute pathology, at least in paediatric medicine. Further study may be needed in adult patients.
On busy days, when the waiting room looks like a fight to the death between rival creches, I’ve started recording rocking-horse status in the notes. It’s partly to cheer up the next doctor who sees Charlie but mostly because, amid all the pressure to practice evidence-based medicine and pursue QOF points, it feels good to include some humanity. Often in medicine you don’t need expensive tests or a rigorous, multi-validated protocol. You just need horse sense.
Dr Nick Ramscar is a GP in Bracknell, Berkshire
