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Oh yes you can be too careful



‘I feel a bit of a fraud’. Can there be seven words in the English language more bittersweet than this classic opening gambit? On the one hand, you’re about to have your time wasted, but on the other, you know nothing taxing will happen in the next ten minutes, leaving you with spare time to idly wonder how hard Canadian medical exams might be.

Yes, it’s an annoyance, but in a world in which there are patients repeatedly calling GPs by their first name while allowing their offspring to use the scales as a bouncy castle, it’s a fairly minor one.

Not so for patients, however. According to a new survey, patients’ biggest frustration with getting to see their GP is that their ‘symptoms have subsided by the time an appointment is given’.

I found this somewhat surprising: surely the discovery that your condition was entirely self-limiting should be a cause for celebration of your body’s incredible healing prowess, not irritation. And if anything, the decision to take up a now-unnecessary appointment by bringing your no-longer-existent symptoms and signs in ‘for a check’ is yours, and yours alone.

(The correct action if you’re ever the patient in this scenario is, of course, to DNA, thereby gifting your careworn GP a precious breather in which to wistfully research Australian visa requirements.)

I’m somewhat suspicious of this research, which turns out to emanate from the recently-labelled-unsafe-by-the-CQC private GP-on-demand service Push Doctor. On the hierarchy of evidence, surveys commissioned for PR purposes come somewhere between ‘anything endorsed by Gwyneth Paltrow’ and ‘getting a one-armed man to kill your peer reviewers’.

I was previously unfamiliar with Push Doctor, but it appears to be one of these new Uber-for-primary-care companies which use the magic of the internet to connect the acute-on-chronically-hypobenzodiazipaemic with GPs who are chillaxed about exorbitant indemnity costs.

I can see the appeal of serving that cohort of patients who are simultaneously both desperate to complement their viral URTI with a side order of thrush and yet unwilling to wait five hours for an A&E SHO to do it for them; it’d certainly give a fellow plenty of downtime in which to casually Google ‘how to fake your own death’, should he choose to do so.

But wouldn’t it be nice if we could persuade people that waiting to get well on your own is very often the best course of action? That you can be too careful? That timely recovery from minor illness, far from being fraudulent, is just a normal part of life? ‘I decided to cancel, because I’m better’ might be the nicest seven words of all.

Dr Pete Deveson is a GP in Surrey. You can follow him on Twitter @PeteDeveson