Annoying things about General Practice: Number 1

There are many laws and rules of surgery, Courvoisier’s, Goodsall’s etc are all frequently true and very important. An even bigger pain in the backside than a fistula-in-ano however is the need to interact with GP land.

Imagine the scenario, the GP calls up the surgical registrar to discuss a patient, probably because they want the patient admitted to hospital.  They have absolutely not said to the patient “I am going to call the hospital to see what they suggest, perhaps they will bring you in” they have told Mr Abdo Pain that he is going in and that he should pack a bag, 90% of the time there is no way are they calling you for advice, they want an admission. So the stakes are high, you can hear the stress in their voice as you say “Oh, I see, 9 weeks of pain and they haven’t required any analgesia, perhaps an outpatient appointment is all that is necessary”…no way is that going down, so they play the pancreatitis or the ischaemic gut card and bingo, they are in the door. They know that you know, they know themselves, the patient even knows, everybody knows, it is a game of chess and I almost always let them win, I don’t really care, make the people better and make the people happy. I am not a management monkey trying to keep the hospital empty and the sick people at home awaiting outpatient appointments, in you come and I will see to you all.

Conversations with the GP begin in one of two ways depending on how I introduce myself.

The game begins as soon as you take the call from the hospital operator, one of two scenarios occur.

Scenario 1

Hospital doctor: hi this is John surgical reg on call

GP: Pah! This is Dr Fussybreeches, specialist in family planning medicine and senior general practitioner in Drumhill Medical Practice West Wing, I have a patient that I want you to admit. What did you say your name was? Dr? 

Scenario 2

Hospital doctor: Yes, hello? You have paged Mr Bigcock, specialist registrar. I am the on call surgeon

GP: Hi, it’s Fiona Fussybreeches, GP in Drumhill, just looking for some advice….

These next scenarios never, ever occur….

Scenario 3

Hospital doctor: hi this is John surgical reg on call

GP: Hi, John it’s Fiona Fussybreeches, GP in Drumhill, looking for some advice….

Scenario 4

Hospital doctor: Yes, hello? You have paged Mr Bigcock, specialist registrar. I am the on call surgeon

GP: Pah! Dr Fussybreeches here, specialist in family planning medicine and senior general practitioner in Drumhill Medical Practice West Wing, I have a patient  I want you to admit. What did you say your name was? Dr? 

Dr Fussybreeches, Fiona, I don’t give a monkeys what you call yourself, I speak to far too many of you to remember who you are, or who you sent me, or where Drumhill or Marychapel or Depressingside is. The GP’s I know and remember are: ones who are my friends that I went to Uni with, my own GP practice GP’s, GP’s who are married to hospital doctors I know and that is the extent of it. Get over yourselves and decide if you are Dr Fussybreeches or Fiona Fussybreeches, but please, stop doing the opposite of what I do in order to gain some minor psychological advantage either by asserting your authority or by your laid back no use of titles.


Radio 4’s Powerful Women

Radio Four’s Woman’s hour today was all about how young girls handle the pressure to have sex. One girl said a very sad thing about a boy who had stuck his hands into her pants whilst a big group of them were all watching a DVD together on a couch with a blanket over their laps. She said she couldn’t say anything at the time as she didn’t want to make a fuss, so she let this boy (apologies here for the terminology) poke her even though she hadn’t wanted him to do so. It isn’t too hard to imagine that if we fast forward five year the same girl will be telling herself that the date rape she has just endured is not worth making a fuss about. Horrible stuff.

Woman’s Hour is generally very good, it used to coincide with my children’s morning nap and as TV at this time is so grim (Jeremy Kyle, repeats of Come Dine with Me etc) I started listening to it whilst on maternity leave with a cup of tea and a huge slice of cake, when breast feeding meant I could eat for Britain and not put on any weight.

Anyway, they have published their list of the 100 most powerful women in the UK, some of them I have even had the pleasure of meeting. Women such as Victoria Beckham and Professor Sue Black must surely be unlikely bedfellows but they are both there, I have to say that they are both hugely admirable but are they equally powerful? I don’t think so. Nicola Sturgeon, Scotland’s Deputy First Minister is on there too, she is the 20th most powerful woman in the UK if you can believe that.

No matter how powerful some women become, be it as supreme sovereign or chief medical officer, it is still the case that 15 year old boys will stick their hands down some poor girl’s pants and she will feel powerless to say no.

Hard to imagine Hilary would shy away from making a fuss

Hard to imagine Hilary would shy away from making a fuss

Oh Daddy Pig, you are silly.

Peppa Pig perpetuates negative male stereotypes

We love peppa pig in our house, it is our most watched and  requested tv show. Even my three year old can recognise the words “peppa pig” on the what’s on tv listing. The gist (for those of you who are not subjected to this sort thing)is that peppa and george live with mummy pig (competent, has a job, is able and normal) and daddy pig (architect, overweight and portrayed as a complete buffoon). George is only about 18months old and all he can say is “dinosaur” and his older sister, the eponymous heroine  is a smart arse 4ish year old piglet who has lots of friends and rarely shuts up.

I dislike peppa pig because;

1. There is a subversive message that men are stupid. I think men are a bit stupid but I don’t want my son being told he and his kind are eejits whilst there’s still a chance I can mould him into a perfect man. 
2. Miss Rabbit works too hard, she is the  bus driver, shop worker, midwife etc. 
3. Jumping in muddy puddles, her catch phrase is “everybody loves jumping in muddy puddles”. This  is not acceptable behaviour, not everybody loves it. I think it should be qualified with “when they have their wellingtons on and mummy says it is ok”.  
4. It’s only 4 minutes long, not enough time to dry my  hair, phone someone, etc
5. It’s on the advert channels only and so I must endure “I want that” endlessly whilst waiting for the next one. 
6. They are pretty greedy, even for pigs. 

There is a PhD for someone on the subject of daddy pigs gross ineptitude and what impact this will
have on a generation of little boys.  Mummy pig barely tolerates daddy pig and seems to treat him like a teenager  “oh daddy pig, you are silly” is her constant cry when she isn’t pointing out to her kids how fat daddy’s tummy is.  The poor man is trying his best, he is a kind and good father but mummy pig (who is also on the large side) puts him down all the time. One has to wonder if mummy pig is as demanding and critical in bed.  As much as Mr KBW is a work in progress, I wouldn’t want my children to pick up on that fact.