Doctors suck

Most of them, that is. And this is not a statement I can make without pissing off a number of my close friends, who are in their community service year of medicine and ready to be unleashed on the world to do the same thing as the protagonists of this post’s title (be doctors, hopefully not suck, that is).

It is my general aim in life to avoid going to the doctor (and I should be specific here: I mean the GP; my encounters with surgeons are thankfully rare, but in all cases, necessary) like the plague: not because I am afraid of them, not because I don’t fall sick from time to time, but because for the large part, I don’t believe they add any value to my life. The dentist, yes – he does preventative maintenance on my teeth, removes the inevitable plaque build-up, reinforces the enamel with fluoride and whitens them. I make twice-annual appointments, I go to his office, I wait about five minutes to see him, he does his work, I see the pleasing manifestations thereof, I pay him his rather large bill quite willingly. I am a happy dentist customer – in fact, I look forward to my visits.

So why can it not be the same with the GP? Not having been since 1999 (except in the case where I needed a renewed prescription for something) I think I forgot all the reasons why I despised them so much, but I will now relate these to you, so that you can share in my ire (do not attempt to appease me please, I want to be pissed off. Thanks).

What time was my appointment again?

I arrived at 9am (technically 8:55am) yesterday morning for my 9am appointment – that’s what people in the business world do when they make meeting times. If you want me there for 9am, then I’ll be there for 9am. If you don’t want to see me until 9:40am, then kindly inform me before the fact that this will be the case. I was told mine was the first appointment of the day, so why on earth was he seeing another patient before me? (“Was it a sudden emergency?” I asked of the receptionist. “No, just his first appointment,” she replied.) Oh. So you book two people, make one wait while you see the other one, boot them out after a certain amount of time, shuffle the next one in, see them for some amount of time, kick them out, herd the next one in ad infinitum (actually, only until 4:30pm. Heaven forbid you expect your doctor, who is actually a businessman trading in his medical services, to put in the occasional late evening. Only people in the real business world have to do that, you see. Us poor lowly un-MBBCh’d creatures.). What really grates my cheese about this was the nonchalance of the receptionist – she looked at me in a very surprised fashion when I suggested I might have other important things to do that day, and acted like I should have expected to wait for the appointment. She didn’t come anywhere near offering an apology for the delay (neither did the doctor, for that matter). If I’d left, they’d probably still have had the nerve to charge me my consultation fee for failing to cancel the appointment less than 24 hours before it occurred, but I’m pretty sure I’d not be able to convince them to pay me for my lost time – it’s not like I don’t have an income to earn, after all. Or is it that my job is less important than yours?

I’m going to prescribe something for you, whether you need it or not

My doctor friends have confirmed this for me – a GP will bow to your whims and prescribe drugs whether you need them or not, because it feels psychologically better as a patient to know you haven’t forked out your consultation fee for nothing – you’re getting hard-core schedule 5 stuff to zap your ailment, whether or not you need it. Antibiotics for a (virally induced) cold? “In case you develop a bacterial infection now that your immune system is a little down” they’ll whimper. In my mind, drugs are usually designed to treat stuff, not prevent it from infecting you. What you really need to be told is “stop whining, if it’s a sick note you want, I can write a fake one up for you” or “stop dressing like an Oxford Rd hooker at night in the middle of winter – put on a goddamn jersey!” or “take Medlemon and sleep it off, you big baby.”

And we wonder why it is that super drug-resistant bug strains develop (hello XDR!) when we prescribe strong drugs to people who don’t really need them, hence don’t take them properly, hence expose their existing bugs to weaker-than-required levels of the drugs, which in turn develop immunities to them.

[But I must be fair and say that this wasn’t the case with my infection yesterday – of course, in some instances, drugs are truly required (although I did pose to him that it was entirely possible my body would clear itself of the infection on its own, that’s what our immune system is for, after all, isn’t it?)]

I’m going to get all self-righteous on your wayward ass

Now, I expect a GP to tell me all the possible pertinent information about the drugs he’s just so happily prescribed for me. I shouldn’t have to conjure up for him some rather likely scenarios that might be happening in my life to check whether or not the drugs will affect it. Unfortunately, the only way I ever really learn the contraindications of a drug is by reading the package inserts, which are vastly more informative (if somewhat too liberally peppered with medical jargon). See, I’ve learnt that some medication doesn’t go too well with other medication. A while back, when I went on the Pill, the doctor (gynae in that instance) never bothered to tell me that antibiotics reduce its effectiveness. Knowing how frequently doctors prescribe antibiotics, and knowing that people generally fall sick with colds/flu once or twice a year, it is not a highly unlikely event that I’d be taking antibiotics at some point in the future, and accidentally find myself pregnant because the Pill suddenly stopped working. Fortunately, that didn’t happen because I have learnt always to read the damn package insert and look up the words I don’t understand.

Anyhow, back to my appointment yesterday: I waited for him to ask what other medication I might be on, or what other medical problems I might have, in the event that there might be some contraindications for my prescribed drugs (I also asked for anti-malarials, I’m going to Mozam in late October/November). I know for a fact that Larium should not be prescribed to people with certain mental problems, but he wasn’t concerned enough to ask about my mental health. I also know that 10-20% of people on anti-malarials (that’s 1 in 5, not a small percentage at all) suffer side-effects from them, but I had to ask what the side-effects were before he thought to tell me. And the cherry on top, I asked “don’t some antibiotics have any possible effect on any other medication I might be taking?” So he replies: “no, not really, you’re not on the Pill are you?” in a disapproving voice. Now that’s one hell of an assumption to make, and one hell of a judgement to cast. Incompetence is what we call it in the real world.