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 be 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.
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