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So I squat in the waiting room for an hour or so with the clamorous, mewling toddlers, the elderly people with bits falling off them and noisome druggies, browsing the pamphlets warning me how to protect myself against cystitis. I later get shown in for an audience with the GP, who quickly confirms my diagnosis and bungs me the requisite ’scrip. This procedure is absolutely invariable.
I know what I’ve got when I go to the doctor and I know in advance the most efficacious method of treatment. Now I realise this sounds arrogant, but there’s a lot of information out there, in books and on the internet. The same sort of information given to the general practitioners, in fact. What’s more, GPs are generalists, required to be au fait with every ailment from athlete’s foot to alopecia. Me, I’m a specialist. I know only about the horrible stuff that affects, or is likely to affect, me.
I do not mean to disparage doctors; heaven forfend. They are, on the whole, a touchy, volatile and ever-so-slightly pompous bunch at the best of times, rather more like James Robertson Justice at his most querulous than silky Dirk Bogarde.
While they are better paid than almost any of their European colleagues and are afforded greater professional protection and social respect — I would not doubt that British GPs are conscientious, work hard, are by and large competent and have the interests of their communities at heart.
Their misdiagnoses may run into tens of thousands each year and end up killing a good few thousand of us but, hell, we’re all fallible.
But the inordinate deference we show them — as opposed to, say, lawyers, plumbers or rat catchers — seems to me wholly disproportionate and outdated.
They are the last of the great professional institutions, buttressed by not only social class and a legacy of respect, but also by an extraordinarily protective quasi-legal framework: inept doctors get their comeuppance all too rarely.
One GP, 71-year-old Howard Martin, has recently been cleared of murdering three of his elderly patients by injecting them with too much diamorphine. He did not give evidence at his trial, although plenty of former patients came forward to attest he was a fine practitioner.
However, 12 more cases of patient deaths are being referred by the police to the coroner and charges could always follow.
Martin may well prove to be blameless — but the case brought back memories of Harold Shipman, another GP, who killed about 250 elderly people over the course of 26 years. It was said at the time that he was a killer who simply happened to be a doctor; his profession was mere coincidence or ill-fortune. But this was nonsense.
There are two facts about the Shipman case that are surely beyond dispute. First, he would not have got away with killing so many people had he not been a doctor. Secondly, he would not have got away with killing so many people had they not been elderly. Both these points were made by Dame Janet Smith, who conducted the official inquiry into the murders.
We might add that it was the inordinate deference towards the medical profession (especially shown by elderly people) which kept Shipman out of prison for so long; the notion that doctors always know best and are not to be questioned in their judgments.
Can you, though, imagine the furore if Shipman had decided to murder homosexuals, black people or children? Or how much bigger a story it might have been had he been a forklift truck driver and not a doctor? Along with the undoubted shock of the case, there was a certain air of inevitability. In truth, we understood how it could have happened. He was a doctor, after all — and they were very old.
Smith concluded her investigations with the observation that the system of regulating doctors was “archaic”. She thought there was no effective mechanism for ensuring that useless (or, one might add, plainly murderous) doctors could be brought swiftly before the General Medical Council. Doctors the length and breadth of the country howled abuse at her.
According to the Country Doctors Association, for example, she possessed a “pathological hatred of the medical profession”. Her recommendations were passed on to Sir Liam Donaldson, the government’s chief medical officer and a doctor, who took the decisive and inspirational step of, er, “noting” them.
Since Shipman nothing much has changed. The deference remains. The institutional mechanisms for ensuring that such deference is unquestioning remain in place.
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