What doctors really need to do is become better actors - then patients might even think they know what they're doing

Phil Hammond MD

Some while ago, as a virgin lecturer in medical communication, I proposed a course called "Acting skills for doctors". I got as far as the fliers when my head of department put the brakes on it. "You can't possibly call it that," he mumbled into his lap-top. "But why not, sir? Everyone knows we act all the time." "Yes and everyone knows we drink like fish, but it doesn't do to advertise the fact. Now, I suggest we call it `How to enhance your caring skills'."

Great suggestion. Two months and no applicants later, we were forced to conclude that all doctors must already have excellent caring skills. What other explanation could there be? I've since moved on to another head of department, so it's time to dust off those old ideas and present them as new. Only this time I've got the Lancet behind me. "All doctors need to be better actors," say Canadian researchers in a recent issue. "Only then can we respond to our patients' emotional pain."

There are many obvious comparisons between doctoring and acting: mumbling, hiding behind the props, upstaging the central character, being in the wrong play, forgetting your lines, ad-libbing with inappropriate humour and, worst of all, getting the entrance wrong. Yep, despite nature's helpful colour-coding, there are still a few doctors who try to visualise the cervix through the back bottom, or check for piles in the front one. Some call it gross professional incompetence, but I prefer bad acting.

Even the General Medical Council has jumped on the acting bandwagon with its proposal to check up on incompetent doctors using fake patients. Aside from providing a glimmer of employment for drama graduates, it sets up the tantalising prospect of bogus patient meets bogus doctor. "Good morning. And what seems to be the problem?" "I've no idea." "Neither have I." "I'll say goodbye then." "Goodbye." It'd be funny if it didn't bear such a close resemblance to my own consultations.

I like to think I'm reasonably honest with my patients - I give them as much factual information as they seem to want and I try to get them to realise that medical science doesn't have all (or many) of the answers. A few brave doctors do extend the concept of honesty to include sharing all of their emotions and attitudes with their patients. Usually it's the old self-disclosure-plus-reflection routine. "You're making me feel quite frustrated Mrs Robinson. How does that make you feel?" But occasionally you get a GP who'll go the whole hog. I know a senior partner who summons patients over the intercom with "C'mon Mrs Morris, you great jelly belly. Get your big flabby arse in here." I'm reliably informed that this brightens up the waiting room no end and that even the victims love him all the more for his earthiness.

Clearly, professional decorum dictates that emotional honesty can go too far and there are times when it's wise to disguise your true feelings, eg "I've always admired your upper body" is not the thing to say when you're listening for a heart murmur. So that's when acting comes in. On my courses, doctors are taught to disguise inappropriate attitudes and emotions and "enhance-out" later. One practice I worked in has a "heart- sink" patient football team comprising the 11 most difficult patients (plus two on the bench). After a murderous consultation, the doctor will run out to the coffee room and replace yesterday's heart-sink with today's. It's a marvellous way to de-stress doctors without harming the unwitting clientele of Sunbanks Surgery, 124 Maryvale Rd, West Thursley.

Of course, there's far more to acting than disguising emotions. You have to learn to take on a variety of roles. Some patients want you up on a pedestal, others like an equal partnership and an increasing minority want to dominate you. Alas doctors, like lovers, learn a particular pattern of behaviour early on in their careers and stick to the same role for life. Patients visiting a group practice soon suss this out: Dr Clements is the practice bastard; you won't get much sympathy but you'll be in and out with your antibiotics in 30 seconds. Dr Hughes you have to book three months in advance but she's very good with emotional disasters. How much easier it would be if every doctor offered several roles for you to choose from. So for this term's course, I'll be teaching doctors to consult in the roles of a fit Mother Teresa, a fit Ruud Gullit, a bad Olivier and a burnt-out, divorced, alcoholic bigot. If you feel I've missed anyone out, please let me know before the timetable goes to print on Friday 13thn

News
peopleHowards' Way actress, and former mistress of Jeffrey Archer, was 60
Sport
Romelu Lukaku puts pen to paper
sport
News
Robyn Lawley
people
Arts and Entertainment
Unhappy days: Resistance spy turned Nobel prize winner Samuel Beckett
books
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
Life and Style
ebookA wonderful selection of salads, starters and mains featuring venison, grouse and other game
News
people
Life and Style
Troy Baker and Ashley Johnson voice the show’s heroes
gamingOnce stilted and melodramatic, Hollywood is giving acting in video games a makeover
News
i100
Life and Style
Phones will be able to monitor your health, from blood pressure to heart rate, and even book a doctor’s appointment for you
techCould our smartphones soon be diagnosing diseases via Health Kit and Google Fit?
News
people
Extras
indybest
Travel
Ryan taming: the Celtic Tiger carrier has been trying to improve its image
travelRyanair has turned on the 'charm offensive' but can we learn to love the cut-price carrier again?
Sport
Usain Bolt confirms he will run in both the heats and the finals of the men's relay at the Commonwealth Games
commonwealth games
Life and Style
Slim pickings: Spanx premium denim collection
fashionBillionaire founder of Spanx launches range of jeans that offers 'thigh-trimming construction'
News
Sabina Altynbekova has said she wants to be famous for playing volleyball, not her looks
people
News
i100
Life and Style
tech'World's first man-made leaves' could use photosynthesis to help astronauts breathe
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

ES Rentals

    iJobs Job Widget
    iJobs General

    SAP Project Manager

    competitive: Progressive Recruitment: SAP PROJECT MANAGER - 3 MONTHS - BERKSHI...

    SAP Project Manager

    competitive: Progressive Recruitment: SAP PROJECT MANAGER - 3 MONTHS - BERKSHI...

    Senior Investment Accounting Change Manager

    £600 - £700 per day + competitive: Orgtel: Senior Investment Accounting Change...

    Microsoft Dynamics AX Functional Consultant

    £65000 - £75000 per annum + benefits: Progressive Recruitment: A rare opportun...

    Day In a Page

    Save the tiger: The day America’s love of backyard tigers led to a horrific bloodbath

    The day America’s love of backyard tigers led to a horrific bloodbath

    With only six per cent of the US population of these amazing big cats held in zoos, the Zanesville incident in 2011 was inevitable
    Samuel Beckett's biographer reveals secrets of the writer's time as a French Resistance spy

    How Samuel Beckett became a French Resistance spy

    As this year's Samuel Beckett festival opens in Enniskillen, James Knowlson, recalls how the Irish writer risked his life for liberty and narrowly escaped capture by the Gestapo
    We will remember them: relatives still honour those who fought in the Great War

    We will remember them

    Relatives still honour those who fought in the Great War
    Star Wars Episode VII is being shot on film - and now Kodak is launching a last-ditch bid to keep celluloid alive

    Kodak's last-ditch bid to keep celluloid alive

    Director J J Abrams and a few digital refuseniks shoot movies on film. Simon Usborne wonders what the fuss is about
    Once stilted and melodramatic, Hollywood is giving acting in video games a makeover

    Acting in video games gets a makeover

    David Crookes meets two of the genre's most popular voices
    Could our smartphones soon be diagnosing diseases via Health Kit and Google Fit?

    Could smartphones soon be diagnosing diseases?

    Health Kit and Google Fit have been described as "the beginning of a health revolution"
    Ryanair has turned on the 'charm offensive' but can we learn to love the cut-price carrier again?

    Can we learn to love Ryanair again?

    Four recent travellers give their verdicts on the carrier's improved customer service
    Billionaire founder of Spanx launches range of jeans that offers

    Spanx launches range of jeans

    The jeans come in two styles, multiple cuts and three washes and will go on sale in the UK in October
    10 best over-ear headphones

    Aural pleasure: 10 best over-ear headphones

    Listen to your favourite tracks with this selection, offering everything from lambskin earmuffs to stainless steel
    Commonwealth Games 2014: David Millar ready to serve up gold for his beloved Scotland in the end

    Commonwealth Games

    David Millar ready to serve up gold for his beloved Scotland in the end
    UCI Mountain Bike World Cup 2014: Downhill all the way to the top for the Atherton siblings

    UCI Mountain Bike World Cup

    Downhill all the way to the top for the Atherton siblings
    Save the tiger: The animals bred for bones on China’s tiger farms

    The animals bred for bones on China’s tiger farms

    The big cats kept in captivity to perform for paying audiences and then, when dead, their bodies used to fortify wine
    A former custard factory, a Midlands bog and a Leeds cemetery all included in top 50 hidden spots in the UK

    A former custard factory, a Midlands bog and a Leeds cemetery

    Introducing the top 50 hidden spots in Britain
    Ebola epidemic: Plagued by fear

    Ebola epidemic: Plagued by fear

    How a disease that has claimed fewer than 2,000 victims in its history has earned a place in the darkest corner of the public's imagination
    Chris Pratt: From 'Parks and Recreation' to 'Guardians of the Galaxy'

    From 'Parks and Recreation' to 'Guardians of the Galaxy'

    He was homeless in Hawaii when he got his big break. Now the comic actor Chris Pratt is Hollywood's new favourite action star