Confessions of a GP

Dr Arbury

Dr Margaret Arbury is a GP and a formidable character. In my mind she is a cross between Mary Poppins and Margaret Thatcher. She is in her forties but has the air and dress sense of someone much older and from a different time altogether. Ultimately, she is very unlike the normal slightly fluffy, friendly female GP. As she opens her door to call in her patients, she ushers them in like an impatient schoolteacher. ‘Come along, come along, Mrs Foster, one has other patients to see.’ The patients are absolutely terrified of her and, as she puts it herself, she simply will not tolerate nonsense. Dr Arbury has never married and her real passion in life is horses. General practice seems an unlikely career choice for her and by her own admission she doesn’t enjoy it, but it does enable her to spend a couple of days a week at work and the rest of the time at the stables.

There is a part of me that admires Dr Arbury’s no-nonsense approach. She is a very good doctor clinically and is excellent at diagnosing and treating disease. She is not so good at doing the touchy-feely, sensitive stuff. Any sort of mental health issue tends to be treated with a ‘pull yourself together’-type response and she prides herself at never giving out sick notes to the ‘whining bone idle’.

There are some who respond well to her brutal but often reassuring honesty. ‘Mr Evans, you are not dying of pneumonia, you have a cold, now stop making such a fuss and go home.’ ‘Thank you, Doctor. I was hoping you would say it was nothing serious.’ If she decides that her patient is unwell, however, she will fight hand and tooth to get her/him the best treatment possible. I once heard some poor secretary trying to convince Dr Arbury that there would be a six-week wait until her patient could be seen by the hospital specialist. It didn’t take long before Dr Arbury had the consultant on the phone and was instructing him on exactly when and where the appointment would take place. Getting to the point quickly means that she always runs to time, which is also popular.

The interesting thing for me is how many of the more difficult, needy patients respond well to her. One of my patients is an addict whose alcohol and Valium use I had been trying desperately to reduce for some time. To my amazement, she responded much better to being given a good telling off by Dr Arbury than by my softly-softly sensitive encouragement. The advantage of being a patient in a big practice is that you can choose the GP who suits you. As new GPs, we are often warned not to be too nice and fluffy or we’ll get all the clingy needy patients latching on to us. Some difficult, needy patients often avoid seeing tough doctors like Dr Arbury because they don’t get the sympathy and attention they crave. It sounds a bit patronising but sometimes I think that a firm word and some home truths can do us all a lot of good. Sometimes, my patients need a sympathetic ear and a bit of genuine empathy. At other times, like all of us, they need a good kick up the backside. The difficult part is getting the right balance.