Write down your symptoms before you see your doctor

It is very easy to forget the most important things during any examination, or any discussion. Doctors home in on important clues - When did it start? How did it feel? Did anyone else suffer as well? Has this ever happened before? What have you done about it so far? Are you taking any medication at the moment?

Watch out for 'over-investigation'

Litigation against doctors is now beginning to follow the American pattern, in other words, its becoming a big business! Therefore the doctors are responding with defensive medicine which can lead to unnecessary tests and investigations. Most x-ray examinations of the painful lower-back are completely useless. Similarly, isolated cholestrol tests can be misleading. Ask whether the test will really help your diagnosis and treatment.

Ask questions

If a car mechanic stuck his head under the bonnet of your Porsche you would most certainly want to know what he intended doing. This doctor is about to lift the bonnet on your body, for goodness sake. It is almost as important as your car. So shouldn't you ask questions?

Avoid asking for night visits unless there is a good reason

Requests for a home call have quadrupled since 1990. Calling your GP after you have "suffered" all day at work will antagonise a doctor who thinks that personal health should come before convenience. If you put money before their quality of family life don't be surprised if you are asked to come to the surgery the following morning.

Respect his professionalism

Nobody likes a smart-ass telling them their job. Turning up with the complete Open University Health and Disease course tucked under one arm may not be conducive to the doctor/patient relationship. At the same time, some doctors can be too paternalistic for their patients.

Listen to what he says

If you don't understand, say so. It helps if they write down the important points. Most people seem to pick up less than half of what their doctor has told them.

Have your prescription explained

Three items on a prescription can work out rather dear! Ask whether you can buy any of them across the counter. Make sure that you know what they are for. Some medicines clash badly with alcohol. Even one pint of beer with the popular antibiotic Metronidazole (also known as 'Flagyl') will make you feel very ill. Mixing anti-depressants and alcohol can be fatal.

Decide if you want a second opinion

Ask for a consultant appointment by all means but please, remember that you are dealing with a person with feelings and not a computer. Compliment him for his attention first but then explain your anxiety, and the reasons for it.

Flattery will get you everywhere

Sincere praise is thin on the ground these days. An acknowledgement of a good try, even if it was unsuccessful, will be remembered.

Act consistently with all the staff

Receptionists are not all dragons, and practice nurses increasingly influence your treatment. General practice is a team effort and you will get the best out of it by treating all of its members with respect. The doctor is not God! (The practice manager only lets him think that he is!)

Be prepared to complain

If possible, see your doctor first and explain what is annoying you. Most complaints against doctors are for rudeness and poor communication (and sometimes even a total lack of communication), usually as a result of work pressure. Family doctors now have an 'in-house' complaints system. If you are still not satisfied, approach the practice manager before taking it to a formal hearing.

Trust your doctor

There is, however, a difference between trust and blind faith. Your health is a partnership between you and your doctor, with you as the majority shareholder. Despite everything that this government has done to the NHS, the majority of people who work in it still have a sense of "vocation".

Change your GP, but with care

Thousands of people change their doctor every year. Most of them have simply moved house. You do not need to tell your GP if you wish to leave his practice. Your new doctor will arrange for all of your notes to be transferred. However, like the Doomsday Option in Dr Strangelove, changing your doctor should not be done lightly. The whole point of general practice is to build up a personal insight into the health of you, and of your family if you have one. Going to a new doctor means that he has to start from scratch, which sometimes may not be a bad thing!


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