Monday, 26 November 2012

Why The Who and many of my patients are wrong.

In the 60s Roger Daltry belted out, 'Hope I die before I get old'.  Many of my old patients lament to me, 'Don't get old'. I confess that my standard reply is, 'Surely it's better than the alternative?'

It set me thinking about being an 'older' doctor. It seems to me that there are multiple advantages.

1. After careful consideration of a patient's problem, if I say that I don't know what the diagnosis is, the patient is generally more likely to accept my opinion on the assumption that if an experienced doctor doesn't know, then maybe their problem is truly 'unknowable'. A young doctor would be less likely to get away with such uncertainty.

2. The older I get the more medical investigations I have had. Worried about a colonoscopy? Been there done that. Apprehensive about an MRI-it's not so bad. Afraid of an aneasthetic? Just enjoy the peace and quiet, etc etc.

3. As one ages so one experiences  more and more of the slings and arrows of outrageous fortune. It's likely you will have experienced at least some bereavements, so offering comfort to others is not done purely in a theoretical way.

4. It's quite likely that you will have brought up (successfully or otherwise!!) children. The sighing parent can't pull rank  and complain about sleepless nights (especially if you are old enough to remember the pre-1996 days when regular nights and weekends on-call was a feature of general practice. Getting up in the night for for your own children AND other people's!

5. You may have been blessed to having surviving, albeit aged,  parents, and understand some of the pressures of being 'in the middle' (aged parents above and uni student children 'below').

6. If you have kept a lively interest in lifelong learning you will have built up a store of patients and patient experiences which come to you in a flash when confronted by an enquiring patient today.'Yes I have seen it before....', sometimes brings  degree of reassurance.

7. If a cock sure junior hospital doctor is condescending and rude, you have the option of speaking to his/her consultant whom you may well have come to know socially. (Sadly this last point has been greatly negated by the ubiquitous and iniquitous choose and book system).

8. If you are fortunate to have a stable patient population, you have a store of shared experiences with patients and their families, which facilitates management of current problems, and greatly enhances the enjoyment of the consultation.

9. Rather self important 'executive' types of patients are less likely to intimidate you.

10. You just accumulate more of life-interests, general knowledge, hobbies, travel, all to broaden topics of discussion with patients.

I'm sure my 28 year old GP registrar daughter could counter all of these with the benefits of youthfulness. I just don't think she would 'win'!




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