I had an interesting experience at my GP recently.
I don’t go to the GP very often. Mostly I don’t get sick. Sometimes I treat my own ills or just soldier on. On the few occasions that I have been to see someone about something concerning me, my overwhelming experience has been of being judged and dismissed. I feel that they think that, as a doctor, I should have not only made the diagnosis but also treated myself. In fact, I should have been better way before I thought to come along!
I don’t need a doctor!
I’ve been lucky really. I’ve had very few problems with my physical health. Unfortunately though I now need to do all those things that people need to do as they get older: check my blood pressure and cholesterol, test for faecal occult blood (Yuk!), get occasional scripts that I now, in my new enlightenment, will not write for myself on ethical grounds.
The one thing that I have had a bit of trouble with over the years is my mental health. I have experienced reasonably frequent periods of mild to moderate depression. I have never seen anyone about this because if I am judged as a failure when I have a physical health problem imagine what they will think if they know I have a psychological problem!
The impact of family culture
I come from a family of stiff upper lippers, of people who believe in the existence of laziness and self-indulgence rather than depression. Talking about emotional issues has always been OK but “giving in” to them or seeking help for them is just not acceptable. My early contact as a patient with the medical profession only reinforced that philosophy. It seems that unless a person is completely physically impaired by their state of mind there are no excuses. “Mild to moderate” doesn’t count. Just pull up your socks and get on with it is a clear and unwavering message.
On that background it even becomes difficult to see someone about a physical health problem. If you have something obvious and in clear need of intervention like a broken leg or a heart attack, well, that’s OK - but a bit of joint pain without obvious swelling? General lassitude? Come on! Just get up and get on with it will you!
What needs to change?
It doesn’t cost anything to take someone seriously and deal with them empathically, but it can certainly make a big difference to how that person feels. Personally, I have always left a doctor’s surgery with the feeling that I have wasted their time. That I am possibly a hypochondriac and definitely a bad doctor.
Last week I went to see my wonderful new GP. I’d had a “funny turn” (as usual my problem was non-specific – not like in the textbooks at all) and I needed her to tell me whether any further investigation was appropriate. I was aware that I had been quite stressed but I really needed to know whether this incident was likely to be related to some sort of physical pathology. My cardiovascular family history is not a pretty story.
I mentioned to her, in passing, that she was the only doctor I had ever seen who had not made me feel bad about being there. I said that in the past I had always felt like a hypochondriac when I saw a doctor.
Her reaction was interesting. She said, “even if you were a hypochondriac you would still be in distress and my job is to help you feel better whatever the problem is”.
I wish more GPs felt that way!
Here’s an interesting article from the BMJ about why doctors make such bad patients.
And, if you are a health professional, here’s some reading that may be helpful the next time a doctor asks for your help.