Every GP has a bagful of silly call-out stories, which in retrospect provide very useful dining-out material (one friend of mine was summoned to an "emergency" when a patient discovered a wasps' nest under the eaves) but at the time just send you into an apoplectic frenzy. Above all, this aspect of a doctor's lot causes most stress - especially when the "emergency" occurs in the wee small hours. Of course, many genuine emergencies do occur early in the morning (indeed, heart and asthma attacks are more common then) and one of the big problems of any patient education campaign is that however much you exhort people to think "Is it really a doctor you need?", it's still left to the consumer to decide what's appropriate or reasonable - and when your living room is full of wasps, it can be hard to make a rational decision.
For every 10 silly call-outs, there is usually one that you thought was going to be silly but turned out to be serious. You turn up on the doorstep in a huff, scowling at the cat and cursing a patient who turns out to be in extremis. The big mystery of general practice is, and will always be, why does one patient call out a doctor every time his nose drips whereas another sits at home quietly with crushing chest pain? It's very difficult to judge the severity of an illness over the phone, although to a gambler the odds are always that the standard long-distance advice of paracetamol and a hot water bottle will be enough to get them through to morning surgery. In the days when I did night visits, I gambled quite a lot until I got a nose-dripper who turned out to have twisted testicles. I only visited him because I happened to be in the area at the time, otherwise he'd have been left alone with his hot water bottle, fast becoming infertile. This salutary lesson, that even nose-drippers get seriously ill sometimes, changed my attitude to visiting, and I went to every one after that. True, I still swore at the cat on the way in, but in I went.
I'd like to think the fab new Department of Health "Doctor Patient Partnership" campaign will make an iota of difference to the increased night-time demands of lost rodents and restless legs, but I doubt it. These are symptoms of a much greater malaise - the inability to cope. People, especially younger ones who haven't lived through a war or had a good bout of polio to contend with, are no longer prepared to accept that illness is part of life. If you inhabit this planet for 70 years or so, the chances are you'll spend about 10 of those years feeling under par. A bit sniffly perhaps. Not quite right in the head. Flopsy bunny even. That's just the way the human body does (or doesn't) work. Now if everyone phoned up their GP the minute they felt a bit flopsy bunny, the whole fabric of our society would collapse. Fortunately, most patients are very reasonable and a pleasure to treat. True, those that aren't are becoming even more aggressive - stories of doctors and nurses being mugged, sworn and spat at are now commonplace - but they're still very much in the minority.
Most patients, too, are amenable to education. Some doctors turn up to night visits in their pyjamas, with wife and kiddies in tow, just so the patients appreciate the intrusion. But the real problem, as ever, is that the majority of illness in the UK is pocketed in deprived areas. If you have no job, no house, no garden, no self-esteem, no affectionate relationship and no reason to live, you're unlikely to sit down and ponder Stephen Dorrell's pat little missive about whether the GP is the right person to call. Often, he or she is the only person to call. As an inner London GP said to me the other day; "Life is a pool of shit - and my job is to direct people to the shallow end."Reuse content