Like in all negotiations, things can get tough, and sometimes we have to play hardball; patients know this, and don't expect any less. But some doctorpatient relationships are better than others; many of my colleagues are temperamentally suited to this kind of thing.
They can squabble for fun, whereas I have to really work at it.
So I've changed my approach, because after seeing the Dali Llama visit Ireland to reassure us that being poor will actually make us happier, and that orange kaftans are still cool even though 40 years have passed since Woodstock, I've realised that there is another way; peace, love and rock'n'roll, man.
I'm basically an easy-going fellow, and I don't enjoy confrontation; I like nothing better than to sit back in my chair and let the familiar litany of complaints wash over me, or be lulled to sleep by the gentle strains of the traditional Ritual Of The Sick Cert.
I've learned that to every demand there is an efficient, time-saving, convenient and stress-free response; I just give in.
'I need some sleeping tablets.'
'Certainly, madam, how many would you like, we don't want you going short, do we?'
'I've an awful sore throat, I want an antibiotic.'
'No problem, sir, I'll give you a good strong one, penicillin is so cheap, isn't it?'
'My leg's giving me jip, what about an X-ray?'
'A cracking idea, here's an X-ray form, go straight to the hospital, I've marked it urgent, so what if there's almost certainly nothing wrong with you and some Luddites might consider it a shocking and irresponsible misuse of scarce NHS resources, remember that you have to put yourself first, there is no-one in the universe more important than you, the really sick people who might actually benefit from this investigation can go to hell, let them wait a bit longer, it's not our problem.'
And if the Dalai Lama was here, he'd nod in approval, but gently point out that I'd spelt his name wrong.