A GP’s Open Letter to Young Doctors (Canberra Doctor - Family Doctor Week 2017)

By Dr Louise Stone

Dear Young Doctors,

We get it. We really do. You know you “should” have your own GP, but we are never free in the 5 minutes you have available between shifts on a Saturday afternoon, and besides which, you can prescribe your own Amoxil for the chest infection you’ve had for a week (and you can’t possibly take a day off: no-one else does). And the last GP you saw for “just a script” had you in and out in 5 minutes, which seemed like a colossal waste of time.

Or maybe there’s a deeper reason. Are you worried what a GP will think of you? After all, many senior “colleagues” treat you like something you scraped off the bottom of your shoe, so will a GP also think you’re neurotic? Or weak? Or stupid? What will they say if you finally screw up the courage to talk about your despair, your sense of hopelessness, your feelings of dread when you arrive at work in the mornings? How will they treat you if they know about your secret drinking, or drug taking, or self harm? Or if they know how you suffer violence at home, every day, and feel utterly powerless to respond? Will they laugh at your fears and vulnerabilities, or worse still, will they ruin your career with a mandatory report to the Medical Board? Is it worth the risk?

We GPs have discussed this, and here’s what we want to tell you. We worry about you. We think you should get the treatment you deserve. And we want to help.

You deserve respect and empathy

Doctors are people too. You shouldn’t have to behave like a “normal” patient (whatever that is) and we shouldn’t treat you differently to anyone else. After all, we adapt to the needs of the 4 year olds and the 94 year olds, the intellectually disabled adults and the lawyers. We ought to be able to get the communication balance right: you shouldn’t have to pretend to be ignorant, we shouldn’t treat you like you know everything (or nothing).

You should be allowed to be worried about your health. We understand that treating a young woman in palliative care for her ovarian cancer will change your level of concern about your own abdominal bloating. And we should take you seriously and not shame you for it.

We recognise that the word “resilience” can easily be translated as “suck it up sister and stop whinging”. Or worse still, “your distress is your own fault because you’re not coping well enough”. Trust me, you wouldn’t be in this job unless you were resilient. So, let’s all acknowledge that the medical workplace is often toxic. It’s not your fault.

You deserve quality care

Self-prescribing is not quality care. Seeing a different doctor every single consultation is not quality care. Seeing your best friend’s dad (or your own) or seeing your GP supervisor is definitely not quality care. Try to choose someone you can see relatively regularly, especially if you have ongoing health issues. Choose someone you like and respect. It’s worth booking in advance if you can. Trust takes time.

Good GPs will discuss and negotiate how you are billed, and how you can get in to see them if you really need to. They help you make decisions when you are overwhelmed and they make you feel comfortable so you don’t need to edit what you say. Good GPs don’t know everything, but they know where to find out and they’re honest about the limits of their knowledge and skills. They know their network, and refer carefully, especially with issues like mental health where a good therapeutic relationship is critical.

You deserve confidentiality

Every other patient expects this. You should too.

So let’s get the Medical Board question up front: we only report if we feel the patients are at risk. If the risk is to you alone, mandatory reporting is not required except when sexual misconduct with patients or intoxication at work has occurred." 

You can ask us the question if you need to: “in what circumstances would you need to report this to the Board”?

We don’t think what you think we think

We have our own GPs, who we value. We get embarrassed too. We remember being junior doctors and we still struggle keeping our heads above water at times. We get stressed. We know what burnout feels like. And many of us have had our own battles with mental illness, chronic disease and substance misuse.

We are not just “experts in coughs, colds and paperwork”. We know you are generally a healthy bunch, so you may not have seen us manage chronic and complex care, but we do. We know our profession is not perfect, we know you get inappropriate referrals from us sometimes (“patient is crying, please fix”). But remember, the slightly grumpy GP who rings to chase a discharge summary will turn their slight grumpiness into advocacy on your behalf if you need us too.

So seek us out. Talk to other doctors about their GPs. Come and see us for something simple to see if we are a “match” for your needs, before you need to seek care for the hard stuff.

It’s time to get the treatment you deserve. 

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