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.

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