The job's not all bad

An anonymous reader left a very surprising comment to yesterday's blog, "seems as though you have an interesting life and lots to discuss." If you only knew me, you'd know my life is not interesting which is why I keep this blog. As it turns out I do have lots to discuss mainly because I'm constantly trying to think of topics to type about in this blog, and thanks for the comments, much appreciated.

I had a real irate patient yesterday who made my surgery run past 6pm. He came complaining of a severe earache convinced that he had an ear infection. The pain was similar to the pain with past ear infections and he was demanding antibiotics for the infection. No need for me to ask him what he thought was wrong or what he wanted from me, and when I examined his ears there were normal, at a push I could've convinced myself there was slight inflammation in his painful left ear but no way severe enough to indicate an infection.

I then asked him about what painkillers he was taking for the severe pain. He wasn't taking any, "I don't like taking tablets," so he had severe pain, but felt no need to take anything for it. I don't think I need to explain how irritating that was. As far as I could see there was nothing wrong with his ears, but what I did discover was a swollen lymph node behind his left ear which was extremely tender to touch, probably the source of the pain.

Over the next 20mins or so I explained to him why it wasn't an ear infection and what the node was and why it was causing so much pain. The solution wasn't antibiotics as he kept persisting for, but regular painkillers and to monitor the progress of the node. If it got bigger it would need further investigation, if the painkillers worked it would get smaller and disappear altogether. Even though he agreed to my recommendations, I could tell he wasn't happy and made sure there was a 'safety-net' in place.

A 'safety-net' is how doctors, especially GPs, cover themselves for any potential mistakes or worsening situations of a patient. It generally involves reassuring the patient to come back if their symptoms don't improve or if they get worse or if they have any other concerns at a later stage. In this case I told the patient to come back today or tomorrow if his pain didn't improve with the painkillers and I could then look at him again. As a general rule for most cases the safety-net tends to be 7-10days, but in this case I felt it more prudent to shorten the time so that hopefully he would feel more reassured. He hasn't come back this morning and I don't have an afternoon surgery, so I'll wait to see if he returns tomorrow.

In a few of my blogs I've complained a lot about my job. At one time of another I've mention how I find it irritating, mundane, boring etc etc. I think it's about time I talk about some of the better aspects of the job. Despite what I've typed in the past, there are a few features about my job that I actually enjoy. One is the general respect I get from the public and my own family. Being a GP, or at least becoming a GP means one thing: I am 'Jack of all trades, master of none' therefore I know a little bit about everything. I often get asked about a variety of health problems, some serious, some minor and I'm able to give some advice about it one way or another and I enjoy that ability. If I was a specialist in a particular field of medicine, I wouldn't have a clue about anything else. As a GP I'm not as well respected in the medical profession as I would be if I was a specialist, but then I'm not working for the medical profession, I'm working for the public and there opinion carries more weight.

I once read an interesting theory about the difference of generalists and specialists. As time goes by specialists become more and more specialised in a particular field, they know more and more about one subject which then breakdown further into smaller subjects. Generalists on the other hand keep expanding their range of knowledge to encompass more about more subjects. If you continue down that path, the specialist knows more and more about less and less, whilst he generalist knows less and less about more and more. I like this theory and fall on the side of the generalist, better to have a wide range rather than a narrow one.

Another interesting feature of being a GP is the challenge of extracting information from patients. Rather like a detective, people often come with hidden agendas and different ideas to what they present and I have to pick up on their interactions with me and try to develop a quick rapport with them in order to get to the root of the problem. When I qualify and work in a practice it'll be easier because I will know the patients for a longer period, but right now, I'm still meeting new patients on a daily basis.

Unlike working in a hospital where the patient comes with acute problems that require immediate attention, in a GP surgery the patient has more time and comes with a range of problems, some not even related to medicine and it's often a challenge to find out the problem. I've complained about having to do that in the past, but that is mainly targeted towards people who don't help themselves because of sheer laziness, for others though, certain circumstances mean that they are unable to help themselves and therefore it is very satisfying to draw out their concerns and then attempt to help them.

There have been a few patients who have come with specific symptoms and requests for treatment who with further questioning a wider range of problems have been explored and at the end of the consultation they are often grateful for talking about their problems and felt much better for it. In the 'touchy, feely' world of GPs I guess this is what it is all about and the fact that I've appreciated the experience would suggest that not all things are bad with my job.

I guess the solution is simply, focus more on the positives and less on the negatives. At the moment it's easier said than done, because the boredom and irritation levels of the job can become overwhelming. Having the opportunity to type about this all helps a great deal, although it may bore most of the readers, it provides some perspective for me and hopefully I can begin to complain less about this job and even begin to enjoy it! Who knows!

At the end of the day maybe my expectations are too high. Who actually enjoys their job? I'm guessing those people are in the minority. For the rest, it's all about earning a living to maintain a standard of life and that is exactly what I am achieving with this job. It is the best job on offer with my degree in medicine. It affords me decent pay, good hours and a positive personal life, so maybe that all I need from the job. What about you, do you enjoy your job? If so, why? Please leave some comments.

Take care all,
Thoughts just flow, when do they have to make sense?