We see a huge variety of medical problems. We are the first point of contact for almost all of these problems - we make the diagnoses and initiate treatment.






This is a recent afternoon surgery of mine:
Pregnant woman – back pain.
70 year-old with angina, pulmonary emboli – wants to stop all her tablets.
1 year old – fever.
Young man with anxiety/panic attacks – recovering.
Woman with post-menopausal bleeding – needs vaginal examination then referral.
Builder with a mole – I'll remove it next week.
60 year-old with hair loss, weight gain – ?hypothyroid.
Middle-aged man with chest pain – ?pneumothorax.
Impotence, dragged in by girlfriend – best consultation skills needed!
Woman with poorly-controlled hypertension – reluctant to increase her medication.
Young man, "tired-all-the-time" – likely depression.
Overweight diabetic, aged 67, HbA1c >9% in spite of full range of oral medication – I'll ask our nurse practitioner about whether she thinks it's time for her to start him on insulin.
72 year-old woman, recent episode of L arm weakness, also getting headaches – she has a carotid bruit and raised BP.
And my last on-call:

Loin pain – pyelonephritis.
Child with central abdominal pain – constipation.
Feverish child – viral infection.
Elderly man in our cottage hospital – broncho-pneumonia.
Terminally ill patient – in pain and vomiting.
What a variety. Oddly, some hospital doctors think we spend most of our time dealing with coughs and colds!

With the honourable exception of the geriatricians, there aren't really any true "general physicians" in the hospital service. We've taken on that role, and I for one relish it.

So, what's the down side?
Most of the less complex medical tasks in the practice, e.g. pill checks, diabetic and asthma follow-ups, have been delegated. This means that we're left with the complex problems. That's great, but it leaves us with a huge amount to do in a limited time.

Written by: Michael Harris

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This page was last updated on: 26 January 2008