I had a good day yesterday, and my evening surgery was particularly enjoyable. I say “evening” because it ran from 4pm until 6.45pm which is not really the afternoon, but it would not meet the Government's criterion for an evening surgery. Perhaps we could call it my “tea-time” surgery instead?
One major reason for feeling good was that, exceptionally, I had enjoyed a little spare time in the afternoon. This is a rare occurrence, but a happy coincidence of timetabling and lack of immediate patient demand allowed me to go home for just over an hour. I ate my sandwiches in peace, read the paper and did some piano practice. It should come as no surprise that a break in the middle of the day gives better results than working ten hours with no pause, save a rushed lunch. Except to the Government, who think it is a good idea for me to work another hour and a half immediately after those ten hours.
But yesterday I felt relaxed and on form. I did not feel rushed, and yet I kept to time. There were few patients with complex medical problems requiring assessment and review. By and large I saw people with single problems which we could discuss in some depth, placing it in context within their lives. One patient who came with palpitations has always appeared stiffly professional, but yesterday a tear appeared in her eye as she began to tell me about her major problems at work.
And I saw two new patients in their twenties. A young man had a relatively trivial self-limiting illness but the symptoms affected his ability to do his job, and after research on the internet he was seriously worried about his future career. I was able to explain what was going on and that he had no need to worry. After he left I wrote up his notes and then went to collect my next patient, who was the young woman sitting next to him. From their body language they were clearly “an item”. Again we had a friendly and constructive consultation, and towards the end she asked me “are you my doctor now?” I told her that under the new contract patients are registered with the practice rather than with an individual doctor, and that they can see who they like. Because we appeared to have a good relationship I went on to mention my fear that the Government was trying to discourage personal doctoring, so that in future care can be provided by any doctor (or nurse) sent to do sessions that day. Before she left she asked me to confirm my name “because my partner wants to see you again in future”. In other words, he wants me to be his doctor.
I have been asked the question “are you my doctor now?” before, but it was only yesterday that I twigged its real meaning: “please will you be my doctor”.
The recent dispute between GPs and the Government over extending surgery hours has seemed to be about two groups with different needs. People with health problems who need to see a doctor regularly, who want to see “their” doctor and are happy with the existing hours. And people who are generally well, rarely need to see a doctor, don't mind whom they see, and don't want to take time off work. The latter group is much larger than the former, the Government want their votes and are pandering to what they think are their desires. But my experience last night suggests that young and well people would still like to have a doctor whom they know and trust and whom they can see when illness strikes, as it surely will.