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Working
with your doctor
Written by a GP with
Depression
When the word "partnership" is mentioned
in connection with medical practice, most people
automatically think of the partnership between doctors.
However, the most important partnership, in terms
of delivering good medical care is the one between
patients and doctors.
Amongst other things, partnership means trying to
give your doctor as much information as possible
about how you feel so she or he can properly understand
your situation. This can he difficult when you are
feeling ill, and the following ideas may he helpful:
- Before you go into your
doctor's surgery, write down how you are feeling.
This will help you remember important points
and will help your doctor get a clear idea of
what your symptoms and feelings are.
- Sometimes it can he helpful
to go to your appointment with someone you trust.
You may he feeling very fragile and may not
he able to concentrate on everything the doctor
tells you.
- Mention your most important
concerns and symptoms at the beginning of the
consultation.
- If you feel you might
clam up (especially if your doctor seems a bit
scary) write him or her a letter ahead of your
appointment explaining how you feel. As a GP,
I have often found this very helpful and it
allows me to offer more time than would otherwise
be available.
- If you find your GP unhelpful
consider talking to someone else at the surgery.
Perhaps the practice nurse, or receptionist
could listen. It is better to tell someone how
you are feeling than to bottle it up.
- Be more concerned about
your own feelings than your doctor's. Having
a pleasant chat may break the ice, but if you
are feeling grim it is important to make that
quite clear. If you don't do this, you may never
find out how sympathetic, supportive and informed
your doctor can be.
- If you feel patronised,
insecure, threatened, bullied or unconvinced
of a doctor's assessment and treatment then,
if you cannot express your feelings face-to-face
consider putting your thoughts on paper and
sending them to your doctor.
- Find out if there are doctors
at your surgery who are especially interested
in depression. Their greater knowledge and consequently,
understanding, may open up a wider range of
treatment options to you.
- Writing a diary may also
be useful. It can help you sort out your thoughts
and feelings and as you get better it enables
you to see that you are making progress. Recovery
from depression can often be "two steps
forward and one step back" so this is important.
- Follow-up is very
important and you could always ask your doctor
when you need to see her or him again. Coming
off medicine needs to be managed properly, so
never stop taking a course of tablets without
talking to your doctor. For some people, depression
may be an ongoing condition, with good and bad
patches. These people benefit greatly from understanding
that depression is just as much an illness as
diabetes or heart disease, and that consequently,
they will need to remain under their doctor's
care for the foreseeable future.
I do not want to make any excuses for poor health
care. I know as well as anyone who has worked in
the NHS for 15 - 20 years that it is struggling
to cope with the growing expectations and demands
placed on it. However, doctors can sometimes be
their own worst enemies. Most of us go straight
from school into medicine. Although the training
is improving, the combination of high stress levels,
long hours and in many cases very poor supervision
can result in some pretty tough or exhausted individuals
at the end of it all.
These can be some of the reasons why people with
depression can get such an unhelpful response from
their doctors. We hear stories about doctors saying
things like "Well, Mrs Jones, you 've just
got to face up to the fact that you 're not going
to be one of life's little sunbeams". Worst
of all is to be told to "Pull yourself together"
- which is impossible when you are suffering from
depression.
It really isn't good enough is it? However, you
can rest assured that there are many good doctors
around and many others working hard behind the scenes
to improve this situation. Much research shows that
people who have not had a good experience in the
consultation are much less likely to take any treatment
prescribed (whether it is a medicine or not). In
this situation, patients - people with an illness
- may also not even get as far as taking the prescription
to the chemist, let alone keep taking the tablets
for the time necessary to see any improvement. If
you feel bad enough to seek help, then it is extremely
likely that you need help. Your GP is one person
who can offer help and the first step towards recovery.
Please help us to work more effectively with you
to make sure you get the care, support and treatment
that you need.
© Dr Chris Manning MBBS BSc BRCOG MRCGP
Doctors get depressed too!
If you know any doctors, or you are one yourself,
who would value being able to talk about it in a
friendly and informal way with a fellow doctor,
you should know about the following new helpline
for doctors, launched last October.
DOCTORS' SUPPORTLINE
Tel: helpline 0870 765 00001 www.doctorssupport.org
Open: eves 6-10pm, Sundays 10am-10pm, Tuesdays 9am-2pm.
Closed Saturdays.
- Completely confidential
and anonymous
- Independent (run by the
charity PriMHE)
- Friendly and informal
- Staffed by trained volunteer
doctors
- Offers listening and support,
not specific advice
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