Liam Farrell: The real role of a GP

'I'm an alien,' he said.

‘That doesn’t matter to me,’ I said. ‘That you are an immigrant, a refugee, and alien, whatever, is irrelevant; you are a human, I am a doctor. We treat everyone, that is our vocation, and in a world of avarice and fear and Trump and Brexit and suspicion of the outsider, it remains a noble vocation.’

‘Not that kind of alien,’ he explained, pushing a little button on his watch; his image shimmered for a moment, then two antennae sprouted from his head.

‘We have to use a disguise,’ he said, waggling his antennae. ‘Don’t want scare the native population; you know, anal probes and all.’

‘I’m a bit vague on alien physiology,’ I admitted.

‘I knew it,’ he said. ‘I wanted to see a specialist but apparently I have to see a family doctor first; what would a family doctor know about aliens?’

'Very little,’ I agreed. ‘And as specialties fracture into subspecialties we know less and less about more and more; very soon we’ll know nothing about everything.’

‘Why do I need a referral anyway?’ he protested. ‘On my planet, if we get sick and have to take a break from the anal probing for a while, we can go directly to a specialist. If I have a cough, I go to a respirologist, if I have a hernia I go to a general surgeon (that’s pretty much all they can do nowadays).’

This was a really good question, which forced me to confront the bleak reality of general practice.

‘Because,’ I explained, ‘if everyone could just go and see a specialist whenever they wanted, the specialist would be seeing too many people with nothing wrong with them, and soon wouldn’t be specialists at all. Orthopaedic surgeons would be overwhelmed by back pains, urologists by UTIs, neurologists by headaches. They’d be seeing too much shite; it’s our job to protect them from the shite; we see the shite, and sift it out so the specialists don’t have to see the shite. Some have romanticised our role; the Thin Red Line, The Watchers at the Gate, a pudgy, middle class Horatius at the bridge. But really we are just there to stop the shite; we are the Great Constipators of Healthcare."

‘Yeah, yeah,’ he said. ‘I’ve an awful sore throat, can you give me a prescription?’

Some truths are universal, I reflected.

  • Dr Farrell is a GP from County Armagh. Follow him on Twitter @drlfarrell

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