This week we GPs have been rubbish at lopping bits off you. So says the British Association of Dermatologists, a group of skin specialists who glory in one of the most unfortunate acronyms in medicine. According to them, if you have your skin op performed by a GP rather than by a specialist, you're going from BAD to worse. Recent research presented at their annual meeting suggests that up to half of skin cancers are incompletely removed when your friendly family doc has a go. Conclusion? Leave it to the white-coated experts.

I'd like to say something cutting at this point, but obviously, they won't let me. But it seems a bit rich of these specialists to imply that, once you finally negotiate your way to the hospital Holy Land, all will be well. After all, minor surgical procedures are often delegated to juniors who have less experience than us GPs.

At least, that was how it was in my day, which wasn't that long ago. The approach to training doctors in practical procedures was the time-honoured “See one, do one, teach one”. Except that the first part of that process was often overlooked. Which is why, on my first day in dermatology outpatients, the sum total of my induction in the technique of “excision of skin lesion” was: “The patient's next door, and it's on his forehead.”

Well, it wasn't when I'd finished with him. It was on the floor, and maybe also on the wall. The kind and experienced sister who assisted me helpfully explained, sotto voce, that the key was a “wide excision”. Sound advice, except that suturing the skin at the end of the procedure pulled his eyebrow upwards, Roger Moore-style. The good news was that his minor skin cancer was completely removed; the bad was that he'd forever look surprised about it.

Things got no better on the labour ward, where again, teaching was fragmented and sparse. The ridiculous hours and sleep deprivation didn't help much, either. Which probably explains why, when facing my first episiotomy [a deliberate cut made during childbirth] repair at 4am, after a gruelling weekend on call, it felt like I was being asked to complete a very slippery Rubiks cube. And why I finished the task with the perhaps insensitive phrase: “All done, except there seems to be a bit left over.”

Maybe things are better now. Certainly, the average GP is fully aware of his or her limitations, despite those BAD accusations. For example, I know that, for your coronary artery bypass, I really must refer you to hospital - even though, given the waiting list, it's very tempting to crack open your sternum and see what I can do with some string and a pair of pliers.

Which illustrates a point: our dabbling in all things surgical is not an attempt to brighten up a dull day, though admittedly, excising a sebaceous cyst does feel like neurosurgery when you've spent the morning wading through ear wax. No, it's actually to improve our services to patients.

That's why, for example, I perform surgery on ingrowing toenails. There's hardly any financial reward, there are a thousand and one other tasks I could be getting on with, and the cathartic pleasure of ripping out a stubborn nail is at best fleeting - but it does mean that my patients won't be limping around for so long, able only to wear trainers. Also, it stops the conversation stone dead at dinner parties when I'm asked if, as a GP, I specialise in any proper areas of medicine.

So if your GP whips out the scalpel and asks you to lie back and think of England, what questions should you be asking? First: “Do you know what it is you're cutting out?” Secondly: “Couldn't it be left alone?” And thirdly: “Have you done this before?” You're looking for a yes, no, yes combo before you let him strut his surgical stuff. Though you may want to chuck in a fourth, especially if you're a particular middle-aged lady with an unsatisfactory sex life. Specifically: “Was it you who sewed up my episiotomy?”

Explore Health

• Expert Advice

• Health Features

• Mental Health

• Alternative Medicine

• Child Health

• Health Club