Remember a £97 million government scheme announced in November aimed at protecting frontline NHS staff from violence? No, me neither. But a report this week points out that the proposals included personal attack alarms for healthcare workers. Apparently, none of these has been issued yet. And the suits haven't even decided whether we GPs deserve them.

Ironically, our obsession with personal security stems from the extended hours imposed on us by Gordon Brown. Those extra hours are likely to be worked in isolation, at night, and in health centres that might as well have a flashing neon sign saying “Class A Drugs - All-U-Can-Steal”.

Thankfully, most of the abuse I receive from patients is pretty tame. Although, not long ago, an elderly and intractably constipated chap did chuck something at me while shouting, “ . . . and you can shove these up your arse”. Which is true, because they were suppositories.

The only other recent excitement involved our senior partner sending an e-alert requesting immediate assistance. Instantly, doctors, nurses and receptionists converged on his room, expecting him to be grappling with an axe-wielding maniac. He wasn't. To our disappointment, he was quietly consulting a well-known, frequently attending, time-consuming heartsink who, though a source of mental anguish, never causes us physical harm. The GP's elbow had inadvertently leant on the alarm button, which is what can happen when you doze off during a consultation.

Verbal abuse, on the other hand, is pretty common and ranges from frank insults to subtle slights. Take this genuine dialogue, which involved a patient I'd never seen before.

Patient: “I've been coming here for years; no one has sorted out my problem and all the doctors here are crap.”

Me: “If that's the case, why have you come to see me?”

Patient: “Because I've heard you're marginally less crap than the rest.”

I must remember that phrase next time I'm trying to dream up a mission statement.

More subliminal is the patient who I've just indulged with 20 minutes of prime consulting time. This one I've played by the book, just like a proper Fellow of the Royal College of GPs. OK, this is probably because we're on video as part of the practice's training reaccreditation and the standard 30 seconds of perfunctory chat about his itchy bottom, the quick prescription and the gentle shove out of the door doesn't give the inspecting team much to get their teeth into. So I've explored his ideas, established his concerns, discussed his expectations and involved him in the treatment strategy. And only then do I shove him out of the door. At which point he utters those crushing words that deflate every GP. “Thanks anyway, doctor.”

“Thanks”, fine. But “anyway”? The subtle barb hangs in the air even after the patient has left, like a bad smell - a reminder that there was something rotten about that consultation.

It only clears as I immerse myself in the final patient of the day. “I've come to you, Dr Copperfield, because the last doctor I consulted was bloody useless.” This feels like another, “Marginally less crap” moment. I nod as he requests antibiotics, a scan and referral to a “top specialist”, as though I'm giving this serious consideration. Which is when I notice that the previous consultation was, in fact, with me. True, it was some time ago, and “Dr Bloody Useless” has had his hair cut and put on some weight since then. But his diagnosis and attitude remain the same.

So, as I point out, I've just been insulted, and therefore I'm quite possibly hurt. Any hope of an apology evaporates, though, as I note for the first time that the patient is considerably bigger than me, is heavily tattooed, has no neck and appears to be a bit cross. Now, where's that personal attack alarm?

Dr Copperfield is a GP in Essex. He also writes for Pulse magazine and Pulsetoday.co.uk

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