What I think about during clinic - part two

3. URTI

URTI (upper respiratory track infection ie the common cold/coughs/sore throats). URTI. URTI. URTI. Repeat script. URTI. INR. Script. URTI. URTI. URTI.

"My throat is really dry and sore. I feel yucky and cough up this really gross... stuff." The patient would pause for dramatic effect and frown in disgust. Perhaps not realising that the doctor just heard this twenty times that morning and has switched into autopilot mode.

"Look, there's no temperature today, your throat is fine, ears are fine, lungs are clear, it's a probable viral infection and should just clear up by itself in a few days. Plenty of rest, fluid and Panadol. Wait, oh, I didn't check your throat yet." I giggle silently and think, I knew it was a scripted response!

(By the way, doesn't it make you feel uncomfortable to think that the bored medical student, sitting at the edge of the examination bed, gazing out of the window, half reading a handbook, stifling a yawn, is quietly but surely observing and critiquing each word and action, and maybe even sensing your feelings and thoughts during the consult? I think I would feel quite self conscious if the roles were reversed.)

Instead of typing the same notes again and again, slowly with your two finger method, why not use a copy paste template for URTI notes? Would it not be better use of a doctor's training and health care resources to have URTI clinics run by community nurses? Only problem would be that occasionally, the presumed minor illness may be the start of something more serious.

OHCS makes me laugh. In regards to minor illnesses the first paragraph reads "...GPs do not have a sufficient monopoly of this to justify being called 'triviologists'"

4. MC

The only reason many URTI patients go to a GP is for a medical certificate (MC). Several weeks ago, if not for that precious piece of paper, I wouldn't have driven in a half awake state, waited in a clinic (not for very long), and have a (very lovely and comforting) doctor diagnose something that anyone off the street could diagnose.

Whilst medical certificates are probably needed for year 12 students who are unable to sit major exams, or for prolonged inability to attend work due to a more serious medical condition, our society seems to be obsessed with them. A seven year old child's mother asked for one because the swimming instructor required a medical certificate for non attendance. Surely for primary aged children, a note or explanation by a parent is sufficient.

It's as if schools, organisations, workplaces assume that a doctor's signature automatically makes an illness and off days legitimate. Which is untrue. If you're keen, it's easy to fake symptoms. Even for an URTI the GP decides arbitrarily how long you should rest for - maybe a day, maybe a week. Regardless of whether you offer a convincing story or not, if you visit the right GP, or enough GPs, you will find someone to happily print an MC for today's, or even last week's illness - if you're lucky. The huge emphasis on producing medical certificates for everything means that GPs spend large amounts of time on unnecessary paperwork, rather than clinical medicine. Again, poor use of health care resources.