I went with my daughter today to see the GP. At eighteen years old she has been having two years of menstrual problems and has been seeing various GPs in our Practice. We have a range of GPs, and I have for two decades managed who I see for what kind of ailment depending on their unique strengths. So, the clinically excellent but non-existent bedside manner doctor was terrific when I developed unusual conditions like trigeminal neuralgia or erysipelas, but hopeless with anything gynaecological or hormonal. There have been growing numbers of female doctors who have been more understanding of such issues but who often work only two days a week. Another GP has a surgical special interest and is terrific for removing BCCs, but just as none of us has all the skills and abilities we could wish for, so our family medics also have varying levels of prowess.
We were lucky today. After thirty minutes of calling first thing this morning my daughter secured an afternoon appointment with our favourite doctor. I have yet to see this clinician without marvelling at the way she manages her time, gives full attention, offers choices, and thinks laterally. Today was no exception. There isn’t currently a cure for the problems my daughter has, merely options all of which have varying impact and side effects. For almost two years she has been working her way through the options, patiently, resigned yet somewhat dissatisfied with her lot. That the GP is equally patient and acknowledges that there is no solution, and shows sympathy but not indulgence is something I recognised today.
What I had not previously recognised was how difficult it must be for all clinicians but especially GPs with the numbers of people they see each day, and the vast range of possible presenting problems, to decipher the needs of the patient in the time available. My daughter is an educated and intelligent young person, but makes for a monosyllabic and shoulder-shrugging patient. If she were in the legal system, I am sure she would not be considered a credible witness. I only went with her today for moral support – usually she goes alone – and observing her lack of information giving, her vagueness of detail and her gauche demeanour, I wondered not for the first time if we all clam up when in front of the GP and why. But I also wondered once again at the ability of the doctor to focus her questions on the next steps of the process, whilst also educating the young woman in front of her. That she did all of that, in only ten minutes, dealing with an ongoing intractable issue with sensitivity and pragmatism, helping my daughter decide on the next stage of treatment, yet not promising miracles, appearing to be an enduring source of support for her, and was no doubt ready to do it all again in the next ten minutes, made me stop and think.
The knowledge and skill we take for granted, the time management and pharmaceutical knowledge, including the dictates of current evidence, is built into the training and continuing professional development (CPD) but the light touch compassion, the realistic acknowledgement, the determination to keep moving forward in trying new approaches, the ability to be there, beside a teenage girl, like a more informed big sister, non judgemental, worldly wise and yet individually focused, that is quite something for ten minutes. Maybe not everyone feels this way about their GP; maybe not all the patients in my practice feel this way about this GP, but when we do, we need to tell them how we feel, to thank them for doing their job with that little extra something. Because although they are doing their job, and much of the above is part of that job, I suspect the little extra that makes us feel heard and helped comes from their humanity. Even if we only see our GPs for less acute health issues, to be able to continue with our lives and the functioning of them, a trip to the GP can be a sustaining part of life; knowing they are there, when we need them, to help nudge us on our way, is a benefit we should not take lightly.