MEDICAL MATTERS/Dr Muiris Houston: Doctors are people. That may seem so obvious when printed on the page, but beneath the surface of that simple three-word statement lie cross-currents of conflicting emotions. The professional persona competes for space with the parent, the partner, the bad back and the difficulty in finding a locum to ensure the family gets its annual two-week holiday.
So what, I hear you ask. Isn't this the way of modern life, whether dispensing medical advice or crunching numbers for a living? Well, yes and no. Maybe because of our medical training, or more likely because of the responsibilities we feel when our patients place their lives in our hands, it can be difficult to stop "being a doctor" when the consulting room door closes in the evening.
Some have blamed this on the "doctor is God" culture which existed in medicine and society until relatively recently. Others dismiss the deeper psychological aspects of the conundrum and simply point to research which shows that eight out of 10 GPs feel excessive work-related stress. This week's British Medical Journal carries research which shows that one in five family doctors in England intends to leave active practice in the next five years.
Morale is also low in the Republic; the medical manpower crisis here continues to worsen. At the same time the national primary-care strategy, while exciting and challenging, will mean huge changes in the way doctors work. The days of the avuncular, single-handed practitioner - the family doctor who looked after all your physical, psychological and even social needs - are most definitely numbered.
I came across the writings of Mark Zaffran - a French GP and author - for the first time over Christmas. One of his pieces, "How to look after your doctor", ["Comment Soigner son Medicin"], struck a chord:
"A doctor isn't necessarily someone who's always patient. A doctor isn't someone who works for the happiness of mankind, but because being a doctor is a job. A doctor isn't someone who likes people to be ill, he's someone who'd like to treat only people in good health. A doctor isn't someone who likes handing out medications; if he does it is because the laying on of hands doesn't do any good. A doctor is someone who wants to strangle parents when they threaten to give their kids jabs if they don't behave themselves. Because a doctor is someone who feels sympathy for some of his patients; and dislikes others.
"In short, if you didn't know (and if you'd forgotten, it's not a bad idea to remind you of it) a doctor is an individual like any other. He has a car that doesn't start, problems with the tax man (yes, I know, there are problems with the tax man we'd all like to have . . .), an inflammation of the knee that prevents him doing his 10 kilometres three times a week . . .
"So, when you think about it, he has just as many problems as you, this man. A few more perhaps. For you, the crick in the neck that came on this morning, getting up is almost a godsend, you won't have to go to work today, and then it'll go, in three days the last twinge will be gone. Whereas he'll still be a doctor once your neck is cured and you've forgotten his existence and thrown away his prescription. Because, being a doctor is incurable!
"Now a doctor is someone who gets worn down if treated badly. For a doctor to be useful, operational, well-performing, and if he's to last a long time too, he needs to be handled gently. Are you going to consult him? Are you quite sure you've nothing serious? Well, make a little effort! Smile at him when you come in for the consultation, that will cheer him up. Ask him for explanations by making it clear to him that it's just to inform you, and not to annoy him; this will set him at ease. Tell him that you don't necessarily need treatment if it's not necessary; he'll have the illusion that you are being cured simply by seeing him. Advise him to take holidays (without saying he looks tired, that will annoy him). In three words, look after him . . ." (Translated by Iain Bamforth in the British Journal of General Practice, December 2002.)
I have had many patients who have "looked after me". It has definitely made it easier to look after them.
So, next time you visit, ask your doctor how he is feeling. Draw the human out of the professional. Don't treat him like deity; underneath it all, he's just the same as you and me.