Thursday, 11 April 2013


An unusually busy day, like those I had frequently before I cut down my hours. There are full surgeries, a bulging tray of paperwork, four visit requests (three visited, one asked to come in), telephone calls and referrals at the end of surgery. Fortunately no further work arose from being on-call. Also fortunately none of the patients were particularly demanding. The one saving grace was that I finished by 7.30pm.  Feel weary all evening.

I am pleased that despite the pressure of work, I remained calm and explained things in a matter-of-fact way. My main problem seems to be assembling all the facts and holding them in mind during the consultation. This usually involves careful reading of the notes before the patient comes in, and then careful elucidation of the presenting complaint. It's hard to argue that I shouldn't do this, but it all takes time and I seem unable to cut corners. Occasionally I am frustrated by discovering (after the patient has left) that I followed exactly the same mental processes when considering the same problem five or ten years ago, but it is not possible to read the entire medical record before each consultation.

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