General Practioners Who Don’t Like Practising General Medicine

This is going to be part rant, part question, part ramble about why doctors bother to practice general medicine if they can’t be bothered with common complaints. 

It just seems so pointless and utterly sad that a doctor practice in a job where coughs and colds and sore throats are common place, if they have no interest in treating those patients.

Or that a doctor practice general medicine when they have no interest in patients with chronic conditions when chronic conditions affect so many of the general population.

I am reminded of Elizabeth‘s battle in Canada to find a doctor who will treat a chronic condition.  Every doctor she tries for help only wants healthy patients.  That is just crazy!

Plus I am reading “Encounters with the Invisible” by Dorothy Wall (ISBN 0870745042) where she discusses how many doctors have lost the art of listening to their patients.  Modern medicine is so focused on tests and such like that they listen to the science and the body more than the patient.  That the majority fail to really hear what the patient describes to them about their condition and that is their described symptoms do not match the test results they dismiss them.  Why is it, she asks, that doctors who are faced with a patient who suffers symptoms which do not fit with current diagnostics do not want to investigate, to try and solve this mystery of medicine – why is their curiosity dulled?

I also read an article this week asking why doctors are so fearful of prescribing pain medication long term to patients suffering chronic pain.  Saying that those with chronic debilitating pain should have pain relief and suppression not “management” which so often means learning to “not focus on the pain”.  She suggests that if doctors are so reluctant to improve the quality of these patients lives by giving pain relief and so fed up with paperwork perhaps they should pursue a career in pathology or some other kind of medicine.  Just leave patients to see the doctors who actually want to heal and where they can’t heal help their patients.

All of which has me thinking that some doctors are just stuck in a job, like millions of other people – lost in a routine that isn’t their calling, doesn’t push their buttons, isn’t a good fit.  The difference is that whilst they linger in jobs they don’t excel at – patients suffer.

Having had this cold with sinus and throat infection for three weeks now and having had a profusion of green snot followed by a discovery of white lumps on my tonsils I finally went to the doctors yesterday.

I’d done some internet surfing and a few sties including www.patient.co.uk which I know is used by my surgery suggested if your sinus problem hadn’t cleared up in 7-10 days, especially if you had green snot (a sign of possible bacterial infection) it was best to get your GP to check it out.  Just in case you need antibiotics to clear it up.

Growler went to the pharmacy this week and saw the Lovely Friendly Lady Pharmacist who spotted he was still under the weather.  After a bit of questioning about him and me she insisted that if we weren’t better by the end of the week we should see our doctor to get it checked out.  After all, she said, it might be caused by something else that needs antibiotics.  Oh, OK then.

The clincher for me was finding white lumps/spots on my tonsils on Wednesday.  Yuck!  I’ve never seen this before or heard of it – so I did a bit of surfing.  The general consensus seemed to be tonsil stones which I had never heard of.  But there was suggestion on some sites it could also be deep infection in the tonsils.  I also read that if you get infection in your adenoids then it can be really serious – even needing hospital treatment.  Since I had these white spots and wanted to be sure what they meant, and since my throat has been just weird for the last fortnight I decided it was time to get it all checked.  Things felt (feel) swollen, heavy, sticky and irritated in my throat.

Growler managed to get just one appointment for Friday so he gave it to me.  No appointments for my Lovely Doctor or even my Alright Doctor – only one on offer so he grabbed it.

Getting up and dressed is a HUGE effort at the moment as this cold thing is leaving me totally wiped from doing very little indeed.  But I did it and I even had a wash so I wouldn’t offend the doctor! Growler drove me to the doctors surgery and all (!) I had to do was walk to the car and then to the office.

Lets call this doctor I saw Doctor Cow.  Growler said that from the minute we walked into her office her body language was all wrong and she was clearly totally disinterested.  Slouching back in her chair she looked like we were interupting her leisurely afternoon (she was running really late on her appointments by the way – the recpetionist apologised but not her).  I gave a very quick run down of why I was there.  I also told her about the spots or lumps on my tonsils.

I’m not going into blow by blow details but she her tone and manner was a bit off – totally disinterested.  I found myself getting quite hyper trying to engage her interest.

She told me she couldn’t give me anything and it was just a virus and that these things take time.  She asked me “what are you doing about it?” and I told her about fluids, decongestant, paracetamol.  She was no help at all. 

She did that sort of final sentence thing and turned away.  So I asked a second time about the white lumps on my tonsils as that was the thing that was really concerning me.  She said there was nothing it’s probably just mucus I’m seeing.  I hear myself getting wound up and incredulous – telling her it’s not mucus or food and these things are not moving and they are not easy to see.  She takes a second look.  There’s nothing there she says – you’re seeing “frothy mucus“.  Bye.

I was livid.  Growler says “ok?” and I say “Well, she’s WRONG”.  Oh dear.  I was so upset.  I felt humiliated – like she thought I was stupid.  I think I know the difference between mucus and lumps in my own mouth.   

When I look in the mirror in the car the largest of the lumps – the one closest to my tongue has gone.  It must have dropped off in the night.  Which means it probably IS tonsil stones.  When I get home and take a look in better light I can see a pit where the lump used to be, an indentation.  And if I look carefully I can just see the second one behind my tonsil and it’s 3 times the size it was 2 days ago.

What I wanted – even though she couldn’t see the lumps – was for this doctor to be interested and to listen to me.  I don’t go to the doctors lightly – I go because I am concerned or it seems the right thing to do.  What I wanted was for her to say something like “It sounds like it could be tonsils stones.  You get that sometimes when you’ve had a lot of mucus and infection in your throat and/or sinuses.  It’s just a build up off bacteria and nasty stuff.  But they usually drop off – nothing to worry about.”.  I know if I had seen my Lovely Doctor – even if she didn’t pick up in this I would have felt a lot better about everything.

I am left to self diagnose – something which drives doctors like Doctor Cow crazy.  Do they not see they leave us no alternative when they are not curious or even interested enough to really listen?  The photo on wikipedia is pretty much identical to the photos I took of my tonsils on Wednesday.  Yuck.  So I’m pretty sure that’s what it is but am going to have to monitor it myself now.  Here is a friendly article on tonsil stones (no pictures).

A day later I am still angry and hurt and disappointed.  It’s the kind of experience that puts people off going to the doctor – and one day, inevitably, something really serious happens and they won’t go to the doctors.  By the time it’s gets unbearable, or they end up at hospital it’s too late.  If they’d caught it early something more could have been done or chronic conditions could have been avoided.  All because of lazy, bad doctors in the wrong job.

I’m not saying being a doctor is easy.  It’s more a vocation than a job.  So if you’re not good at it – go do something else.  You might save more lives and give better health to a lot more people by not being a doctor and leaving it to the ones who actually give a damn.

UPDATE:

Sorry if this grosses anyone out.

Some lovely pictures of my tonsil stone.  The other one was just out of sight to the side of this one. 

Click for bigger pictures.

Tonsil Stone 17 Jan 2008 Tonsil Stone 17 Jan 2008 Tonsil Stone 17 Jan 2008

 If you look carefully in this next picture you can just see the pit where the tonsil stone was (sorry it’s a bit blurry). Another stone started to gather in that pit some days later.

Pit Where Tonsil Stone Was 18 Jan 2008

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13 Responses to “General Practioners Who Don’t Like Practising General Medicine”


  1. 1 fogggygyrl January 20, 2008 at 4:23 am

    Here Here! I know just what you mean. You explained it well. Perhaps you could publish this or give a copy to The CFIDS Foundation. It’s really good.

    fogggy

  2. 2 mpshiel January 20, 2008 at 9:23 am

    I’m really sorry you had this experience, which is why I am usually too exhausted to go – but to give so many clear signs that you want this TAKEN seriously and for her to be so clear in that whether it is serious or not, she couldn’t give a damn (I mean, I’ve had the, “Well, if you insist, we COULD do a culture/blood sample” reaction which even if it is something, they seem to respond with, “Well, yes, it was the bubonic plague but often patients rebound from that with no treatment at all.”

  3. 3 rachelcreative January 20, 2008 at 10:26 am

    It some ways it silly and minor and like ‘just get over it’. But I think it stings more because with CFS there’s so much that I am unable to do for myself, so many ways in which I am dependent and needing to be guided – that when I know what is what and get the brush off from a professional … it hits me harder. Like I’m standing alone in a deep cavern – not deserving help or to be listened to.

    Like Growler said when we came out of the doctors office – she’s not worth it, no point letting her get to me. Let’s face it – it’s not like she’d be bothered is it? 🙂

  4. 4 Rachel M January 20, 2008 at 5:44 pm

    I was relieved to find out that it was not about your usual “lovely doctor”. I’m sorry that it is not easy for you to make an appointment with your usual doctor.

    There are just too many bad-attitude doctors out there. *sigh*

  5. 5 Connie January 21, 2008 at 3:28 am

    Sometimes I just hate doctors. I’m sorry that you got one that has no apparent interest in her patients’ feelings as well as their general health. I understand completely what you’re going through, unfortunately.

    Feel better soon. (((HUGS)))

  6. 6 cusp January 21, 2008 at 10:54 am

    Hi Rachel. Didn’t realise you had this blog too. Alerted to it by ‘Matthew’ who reached me via you.

    I know just what you mean about GPs too. Years ago I went to my then-GP (before diagnosis) and after what seemed 5 minutes I asked ‘Could I just ask one more thing please’ This was asked very tentatively since he seemed preoccupied and bored and not in the least interested in me. He looked at his watch and said ‘7 Minutes now…..oh, go one then…what else do you want to know ?’
    That was 20 years ago and I’ve never forgotten it and how small and stupid I felt.

    For the past 15 years I’ve had the same GP. He diagnosed me 7 years ago and he’s a lovely man but, all the same, I never bother to go and see him now because it feels like he’s done all he can, said all he can say and there’s nothing left to talk about. Whatever I turn up with ‘it’s the M.E.’, ‘we don’t have the resources’ In a nutshell he’s sympathetic but ineffectual and it’s very frustrating.

    Like a lot of PWME I feel I’m on my own

  7. 7 rachelcreative January 21, 2008 at 11:06 am

    Thank you all. I wish we didn’t share this common experience though!

    Must remind myself that there are Good Doctors out there – even if they are as confounded as we are sometimes by this condition.

    And there are DEFINATELY people out there who care. I just counted 5 right here 🙂

  8. 8 Barbara K. January 22, 2008 at 12:56 am

    I just finished reading some postings on the Happy Hospitalist’s blog. He is anything but happy. He paints an angry picture of the absurd (to him) constraints insurance, administration, and other unthinking doctors impose on his patient care. He is angry.

    Then I just read your post about this dreadful mistreatment you received at the hands of a seemingly indifferent doctor. I have had similar experiences. I actually grabbed onto the white coat hem of a pain specialist who was heading for the door after talking to me for 10 minutes and prescribing a medication I had tried with severe side effects. So I empathize.

    But reading these two blogs side by side left me thinking that that we are all swimming in a toxic soup – our crazy health care system. A soup that leaves patients raging and flailing around for real help and turns too many once-caring-listening doctors into frustrated, impatient, pablum spouting, finger pointing cynics. I by no means mean to diminish the mistreatment you received, but when the system is so broken, it breaks the people in it….all of us, patients and doctors.

  9. 9 Glenys January 22, 2008 at 8:02 pm

    That is sooo wrong! Is Dr Cow the only local general quacktitioner? Perhaps a trip to the ER would be more beneficial for you? Even this ol’ grandma from Australia can “see” there is something wrong with your tonsils that need anti-biotics! But then, I am *listening* to what you have to say.

    I will pray for healing for you.

    Blessings,

    Glenys

  10. 10 Jacqueline L. Jones January 23, 2008 at 3:12 am

    Our health care system has been overtaken by mercenaries. Healthy patients usually have insurance or can pay cash for what little care they need.

    Another problem, as you pointed out, is that many doctors don’t like patients who challenge their sense of superiority with something they don’t understand. Wouldn’t you be upset if you spent half your life in school and discovered you were still incredibly ignorant?

    Doctors are trained to treat acute illness and don’t understand the human body enough to treat the complex nature of chronic illness. I’ve stopped being shocked that I know more about physiology and biochemistry than almost every doctor I’ve seen.

    I’m excited to see more mainstream professionals rebel against the system and embrace alternative techniques that really benefit the patients.

  11. 11 bbabe January 27, 2008 at 8:55 pm

    I don’t understand why doctors just want to dismiss things that don’t fit Perfectly into a little box with just the right lab results and symptoms. They don’t seem to like a challenge where they have to use crtical thinking and look at the sum of the symptoms instead of what everything “should” look like. I don’t think I’ll ever get it.

  12. 12 doctor December 4, 2008 at 7:53 am

    those tonsil stones, called tonsiliths, will stay with you forever, nothing will remove them, they just build up by the next day. You need to remove your tonsils

  13. 13 rachelcreative December 5, 2008 at 9:54 am

    Surgery is only necessary if tonsil stones are causing you a lot of bother.

    For most people they are not a major problem and there are some simple ways to treat and prevent them (info in the articles I link to in this blog post).

    Here’s some more first hand experience from someone who has successfully removed and prevented tonsils stones http://internettradebureau.com/articles/tonsilstones.htm

    Tonsils stones have not proven a problem for me in the last 10 months so advising surgery seems a little over the top “doctor”.


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