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No wonder GPs act like parents when patients act like children

It was a hot day at the end of September, and particularly uncomfortable in my room. I couldn’t open my window very far, as I didn’t want cigarette smoke drifting in or the sounds of my consultations drifting out. My last patient was an extra. We were both hot and flustered.

‘I’ve had this sore throat doctor for, like, two days,’ she began, and I nodded apologetically, but I knew what was coming next.

‘I’m supposed to go on my summer holidays tomorrow. I only get two weeks off a year,’ she continued.

I let her talk as I recalled something my kids had said the weekend just gone.

Dad, remember those sweets  you bought us? It’s the weekend, why can’t we just eat them all?

‘I was hoping you might prescribe me some antibiotics, like the last doctor did, you know, just in case?’

Mum let us have some sweets just before bedtime last week – didn’t she tell you? Oh come on, Dad!

‘You don’t want me to have a spoiled holiday, do you? Are you listening, doctor?’

I spluttered into life.

‘So you’ve had a cough and sore throat, but no fever, and no painful glands up in your neck…?’

She nods her head as she realises I’m not buying it.

‘Let me take a look in your throat,’ I grumble, even though I know there will only be the merest hint of mild pharyngitis. But it gives me time to think.

As I removed the wooden spatula from her mouth and tossed it into the bin, she swallowed, coughed and spoke again to try to rescue her lost cause.

‘Oh go on,’ she wheedled, ‘aren’t you supposed to be the nicest doctor in the practice?’

‘Look,’ I replied, ‘you’ve got a viral illness and sw- antibiotics will do no good. It’s for your own good.’

She got up to leave. 

‘I’m sure you’ll have lovely holiday,’ I added.

It’s hard to not be paternalistic when some patients act just like my own children.

Dr Samir Dawlatly is secretary of the RCGP’s adolescent health group and a GP in Birmingham.