What’s Up [Rude] Doc?!

GPs get paid a lot right? Salaried between £55-85k a year, funded mainly by direct taxation granted to the Department of Health by Parliament which amounted to around £108.9 billion for 2012/2013.

Launched in 1948, the NHS has become the largest publicly funded health service in the world. I don’t take this service for granted and would be horrified to face the lack of access to healthcare in countries like the USA. I have said for a long time that I would be prepared to pay a small amount for access to additional healthcare services like blood tests, basic health advice and a general MOT which would take some pressure off the main GP service because I appreciate that sometimes patients are just looking for reassurance and access to knowledge based on scientific tests. 

Towns and cities are burgeoning far beyond historical boundaries rendering local infrastructure incapable of servicing the needs of expanding communities. Doctors, dentists, schools are all under pressure to accommodate more and more people. That said I would hope that a GP would embark upon their tough career with an element of wanting to help others, to share their knowledge and training for the welfare of their patients and the community.

Yesterday I received a letter of apology from a GP in response to a complaint. He apologised that I had felt he was disrespectful towards me during my first consultation with him. Having attended my appointment regarding an ongoing, common condition I was left shocked and stunned by his odd approach.

Having confirmed my name I sat on the consulting chair and explained the reason for my appointment. The GP, dragging his eyes, eventually, from the monitor before him, turned to regard me. His gaze lingered, almost fixedly, at my midriff. “You have the condition because you are overweight” I was told. Wow. A doctor who can diagnose purely by a 5 second glance. Surprised by this direct and non-consultative approach (he had not asked me anything other than to confirm my name) I retorted “I’m only a size 16, I don’t think that’s massive.” Which turned out to be the proverbial red-rag to the bull.

The now irritated GP then proceeded to demonstrate to me just how large I am by insisting I get on scales, stand under a measure, and stand up to have my waist measured as he briskly calculated the dreaded BMI formula to announce in his conclusion “So you’re obese plus two stone.” Pardon? “Even if you lost two stone you’d still be obese.” He explained and then wrote me out a prescription for 8 months.

In my complaint letter I pointed out that I felt this approach did not meet with the standards of care I should have expected in line with the NHS It’s Your Practice guide. I also noted the recent NICE (National Institute for Health and Care Excellence) guidance which states:

GPs will be expected to ‘routinely’ raise the issue of weight loss in a ‘respectful and non-judgemental way’ to patients

From my experience they seem to be right on the mark with that one. Because adversely I am not opposed to losing weight, in fact I’d like to. But the GPs disinterested, forceful attitude, rigorously calculating a formulaic label for me while not actually engaging in conversation, did not allow for me to express that.

I don’t doubt that GPs are up against patient’s lack of responsibility for their own healthcare, apathy and disinterest on a daily basis. What I would expect though is that highly educated, perpetually communicative GPs should be able to acknowledge, listen to and accordingly address the individual sat in front of them. Without judgement, without assumption, and with a tact.