Jane Haynes describes the increasing distance between the once familiar family doctor and the patients they serve.
Where have all the family doctors gone?
Posted on: Thu 29-Jan-15 11:14:03
(23 comments )
Jane Haynes is a psychotherapist whose previous book was shortlisted for the PEN Ackerley Literary Memoir Prize and was endorsed by Hilary Mantel.
While my children were growing up the welcome arrival of our family doctor to diagnose an acute ear infection late at night was not uncommon. I remember our small son clambering the nursery curtains, pleading for his ‘friend’ our doctor to arrive, driven by the relentless pain. I can also remember our doctor - a dapper man by day - sitting past midnight on our son’s bunk bed and delicately checking his throat and ears.
Dr. Smith, who spent his days in pinstripes, wafted Eau Sauvage and stole wet-lipped kisses from some of his lady patients, but only at his door where he ‘courteously’ stood to bid them goodbye. That particular night however, he had arrived in jeans and an open necked - if crisp and wife-ironed - striped shirt. How young he looked! I had always thought of him as old, but what then took me by surprise as he knelt down by the bunk, was a gold chain and the flash of a most unlikely over-sized and sparkling medallion. At this clash of aesthetic, some of his gravitas fell away and I realised that he was another ordinary man who concealed - behind his day-consulting façade - all sorts of quirks, vanities and clues to another life beyond the limited one to which I had access.
Long retired and dead now, I still have an image of him sitting pinstriped and elegant behind his mahogany desk, fountain pen poised, as he entered in long hand those medical tidings, both benign and malignant in a leather bound manuscript.
Now it is becoming rare for doctors ever to enter their patients’ homes, or even to remember their names before they glance towards their computers. Some futurist physicists like Michio Kaku are predicting that before the end of the century microsurgery will be conducted remotely over the Internet. But regardless of predictions there needs to be something sacred about health: it is the opposite to disease and thus a visit to the doctor will subliminally remind us of our mortality and our prospective death.
Twenty years ago it would have been uncommon for any GP not to know the names of all the families on his panel and likewise we would be able to name our GP.
These days, how rarely are our GPs now available to be summoned in those lonely hours of the early morning, which are most disposed to seeing the dying depart. Whilst we may have to accept that along with the population explosion there are many ideals of leisured medical consultation that belong to the past, there is something awful happening when patients cannot expect to be remembered or attended to, except by a stranger in their hours of greatest need and terror.
During the Swine flu debacle of 2009, I was told by a family member who is a specialist in infectious disease control, that it was not uncommon to witness anxious parents arriving at a medical centre in Lambeth only to be instructed to remain in their car until a doctor in full protective environmental suiting and mask, emerged to thrust a do it yourself swab kit through the car window. What will happen to the doctor and patient relationship when a major environmental infectious disaster strikes at the heart of society? Between one day and the next, and usually without warning a trickster virus can descend, or a stroke paralyse. Too easily we are able to eradicate the facts of the 1918 flu epidemic, which infected 500 million people across the world and killed between 50 and 100,000 million of them.
When something goes wrong with our body, or our children’s bodies, we are immediately vulnerable and liable, if not forced, to abandon our autonomy and place ourselves in what may be an uncomfortable, or even a hostile stranger’s hand. Depending on how ill or vulnerable we feel, we may, or may not fear that we are falling apart. Illness creates disorder: Things fall apart/The centre cannot hold/Mere anarchy is loosed upon the world. We need only to substitute ‘upon the body’, for Yeat's lines to serve as a description for what can happen when we are suddenly taken acutely ill. Many connections are severed and taken away as illness isolates us from the familiar routines of our lives and renders us most vulnerable.
Twenty years ago it would have been uncommon for any GP not to know the names of all the families on his panel and likewise we would be able to name our GP. Today, when I ask my patients, (I am a psychotherapist) if I can write to their GP, it is not for fear of confidentiality that they reply, "No point. He/she would probably have no idea who you're writing about".
Jayne Hayes co-authored Doctors Dissected with Martin Scurr, available 29 January from Amazon.
By Jane Haynes
Twitter: @gransnet
I remember our old family GP fondly. He once asked me when I was aged 5/6 if I had any pain passing water to which I replied, no, I pass the loch every day and I'm fine! He burst out laughing and said to my Mother that it hadn't occurred to him, what a silly question to ask a child. 
Our current GP knows our names, both DDs and both GDs and has been our GP for many years. A lovely old school gentleman who, if we meet outside, enjoy a blether together.
Feetlebaum - 'swanned off on maternity leave' ? You'll be saying next she "got herself pregnant'.
I feel fortunate in being in a group practice, where we can always be seen o the day with emergency stuff or wait to see our chosen GP with the chronic things that go with getting older.
My current GP of choice did 2 years as a registrar with my rhuematology consultant, so I feel lucky. She is also a joy, in her 30s and full of enthusiasm, always smiling and supportive but last time I saw her she talked about working 12 hour days regularly and feeling unhappy with the way the NHS is changing. I'll use the word changing to avoid this thread deteriorating into a political discussion. Maybe that's inevitable
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