Tuesday, 12 February 2008

"Little Medic to Room 6 Please"

I went to see my GP today, and characteristically was a good 15 minutes early, despite the fact the surgery is 4 minutes walk around the corner. Anyway I'm quite happy to sit there and read my book until it’s my turn. My appointment was for 10:20 and the GP registrar was only running 10 minutes late.

The consultation itself was strange. I'm 90% sure the GP didn't know that I was a 5th year medical student and as such, I felt quite patronised at times. I used a number of medically related words which your average lay (or is it ley? I never know) person probably doesn't know, unless they've read in depth on the internet. The registrar was very nice, although a bit bamboozled by my presenting complaint. There isn't a lot wrong with me, it’s more a persistent annoyance than anything else but I thought it’s about time I got it checked out. I'm not quite sure what I was hoping for - perhaps that is why I don't feel particularly fulfilled by the consultation. I think the GP thought I was looking for antibiotics; although I made it quite clear I wasn't (must be a rarity in GPs). He promised he'd phone me back later with some more advice - although he hasn't yet.

It made me think about the complexities of treating medical professionals. I know some of my colleagues go in to see their GPs and tell them exactly what they want. Whether or not they get it is another matter. Some people say that they're a medical student, others prefer to remain anonymous. A fellow medical student came to see me during one of my surgeries recently and whilst it was only for a trivial complaint. I couldn't help feeling ever so slightly awkward. I remember witnessing a consultation between my supervising GP and a patient who was the young son of another GP. It worked very well, and was very professional, much more ethical than treating your own friends and family. I wrote about patients having their own agenda quite recently but what happens when that agenda is an informed one, from another medical professional. It must make things a little harder to deal with when there are differing opinions between the GP and the 'patient'.

Anyway, I'm going back the GP this evening with missbliss and her problem, which promises to be an interesting consultation. I have my own agenda based on my diagnosis (which is pretty barn door obvious to be honest), I know what treatment she needs, and I expect nothing less. Perhaps I’m wrong for doing so, but hopefully the GP will agree and everyone will be happy!


dr_dyb said...

Well for starters I would suggest you don't go in with the attitude from the last sentence! Whilst you may be on a GP block and have read all the textbooks I would expect the GP to make his/her own mind up and use their experience to guide their treatment, unless it is a really straightforward one.

As a student I feel that anyone with the patient alters the interaction and makes it more adversarial.

Also what kind of GP didn't do a Social history and ask about your occupation.? :) Bad Comms skills! ;)

I would always inform my GP because a) it might be relevant to how I caught it b) might affect my clinical practice / studies and c) I;d need a medical note for why i was missing Uni to go to the GPs.

the little medic said...

dr dyb - it really is straightforward! I wouldn't be that arrogant otherwise.

Also, usually the GP is aware of me being a medical student - I just wanted to see what it was like for once when they didn't.

dr_dyb said...

If it is that simple you should have done her a script when you were acting GP last week then!

Anyway, your GP registrar seems to be bad at Social history in communication skills if they forget to check the occupational history....

PhD scientist said...

A lot of doctors don't look at the "occupation", in my experience, and some don't twig even if you use tech-y or "trade" words. Some don't even register if you tell them flat out.

I've seen lots of versions of this, being a physiology lecturer and also going to sundry maternity appts years back with Mrs PhD, who is a hospital doctor. Some people check and change routine, some listen to you and then check, some just... don't.

Worst experience: a couple of years ago I was a "customer" of the general surgery service at a Well-Known Teaching Hospital. During my treatment I saw the consultant, a locum consultant and three SpRs, and not ONE of them had read (or asked) what I do for a living. The SpRs didn't even change the spiel when I told them - they had a set script and they were sticking to it rain or shine, or else they simply weren't listening. The only one of the five that changed his approach was the locum consultant, who actually stopped and then talked to me like I was a grown-up. All in all the team weren't much of an advert for the said hospital or for general surgeons. It was the kind of thing that makes people say stuff like "believe me, every medical student should try being a patient"

The anaesthetist for my minor op, in contrast, had read the file and so I got the full "medical spouse" treatment. The difference was, erm, startling.

Finally, the GP I see is not too bad - he knows what I do, and what Mrs PhD does, so we have "discussions" rather than anything else.

So to sum up, it varies an awful lot from doctor to doctor. Some are sensitive to the patient's "cues" about what level they understand at, and some aren't.

Xavier Emmanuelle said...

It's quite literally my biggest pet peeve to be spoken down to, so I totally feel your pain. Of course, you're much further along in the whole med education than I, but I figure that with two solid years of anatomy, physiology, pathology, etc, I really shouldn't be spoken to as if I haven't a clue what a red blood cell is, or laughed at if I accidentally use a simple medical term like hypertension or tachycardia. I mean, really, I'm not that stupid.
*Rant over*
Right-o, I shall be interested to hear if you and MissBliss' GP are in accordance about her diagnosis!

Calavera said...

Well, if you're that confident about the diagnosis, then I'm sure you've got it right!

If not, then back to the books for you, Little!

Anonymous said...

I remember being told by a GP that if you're a medical student it's best to own up - probably so they don't get caught out if they're not doing something by the book.

And I guess it would save them time explaining things, and would be able to provide more autonomy.

Anonymous said...

I don't see any reason whatsoever why someone wouldn't just tell their doc that they're medical. It makes life so much easier.

Every doc I know hates the routine where people come in and start using medical jargon, and expect you to ask what they do for a living. Just tell them, and let them do what they want with the info.

Dr Thunder