Yep despite nature’s helpful colour-coding there are still a few doctors who try to visualise the cervix

Yep, despite nature’s helpful colour-coding, there are still a few doctors who try to visualise the cervix through the back bottom, or check for piles in the front one. Some call it gross professional incompetence, but I prefer bad acting.Even the General Medical Council has jumped on the acting bandwagon with its proposal to check up on incompetent doctors using fake patients. Aside from providing a glimmer of employment for drama graduates, it sets up the tantalising prospect of bogus patient meets bogus doctor “Good morning. And what seems to be the problem?” “I’ve no idea.” “Neither have I.” “I’ll say goodbye then.” “Goodbye.” It’d be funny if it didn’t bear such a close resemblance to my own consultations.I like to think I’m reasonably honest with my patients – I give them as much factual information as they seem to want and I try to get them to realise that medical science doesn’t have all (or many) of the answers. A few brave doctors do extend the concept of honesty to include sharing all of their emotions and attitudes with their patients. Usually it’s the old self-disclosure-plus-reflection routine “You’re making me feel quite frustrated Mrs Robinson. How does that make you feel?” But occasionally you get a GP who’ll go the whole hog.

I know a senior partner who summons patients over the intercom with “C’mon Mrs Morris, you great jelly belly. Get your big flabby arse in here.” I’m reliably informed that this brightens up the waiting room no end and that even the victims love him all the more for his earthiness.Clearly, professional decorum dictates that emotional honesty can go too far and there are times when it’s wise to disguise your true feelings, eg “I’ve always admired your upper body” is not the thing to say when you’re listening for a heart murmur So that’s when acting comes in. On my courses, doctors are taught to disguise inappropriate attitudes and emotions and “enhance-out” later. One practice I worked in has a “heart- sink” patient football team comprising the 11 most difficult patients (plus two on the bench).

After a murderous consultation, the doctor will run out to the coffee room and replace yesterday’s heart-sink with today’s. It’s a marvellous way to de-stress doctors without harming the unwitting clientele of Sunbanks Surgery, 124 Maryvale Rd, West Thursley.Of course, there’s far more to acting than disguising emotions You have to learn to take on a variety of roles. Some patients want you up on a pedestal, others like an equal partnership and an increasing minority want to dominate you. Alas doctors, like lovers, learn a particular pattern of behaviour early on in their careers and stick to the same role for life. Patients visiting a group practice soon suss this out: Dr Clements is the practice bastard; you won’t get much sympathy but you’ll be in and out with your antibiotics in 30 seconds. Dr Hughes you have to book three months in advance but she’s very good with emotional disasters. How much easier it would be if every doctor offered several roles for you to choose from.

So for this term’s course, I’ll be teaching doctors to consult in the roles of a fit Mother Teresa, a fit Ruud Gullit, a bad Olivier and a burnt-out, divorced, alcoholic bigot. If you feel I’ve missed anyone out, please let me know before the timetable goes to print on Friday 13thn. Being cold-called at eight in the evening doesn’t normally offer anything more exciting than a welcome opportunity to be rude to strangers without feeling guilty about it, but there was something about the portentous tone of the woman from Tesco Direct that hinted at grander vistas. This wasn’t merely a pilot supermarket Internet home-shopping scheme. Here, she implied, was a chance to mould the future of urban society – to be one of just 500 pioneers casting aside the tyranny of the trolley to contemplate a brave new commercial dawn The demise of the British aisles You have nothing to lose but your chain stores. How could I refuse? It would be like having electric lighting in your home in 1880. Or maybe a Betamax video in 1980.
My handbook to the vanguard of the consumer revolution arrived in the form of a CD-ROM containing details of the full 20,000 or so lines on sale at Tesco’s Osterley superstore in west London, and a glossy brochure.

“Specially-trained `shoppers’ select only the finest and freshest products,” they trumpet, keen to assure the paranoid that the scheme is not a cynical ploy to fob off trusting home-bound cybershoppers with bags of stained cod knuckles labelled as smoked salmon.It soon became apparent that one would be placing a great deal of trust in the special training of these shoppers. The CD-ROM contained no illustrations of products, merely an unwieldy alphabetical list of often enigmatic descriptions. It would require a really very special kind of shopping training to teach one to look for Rennies under G for Gastrointestinal. Sausages are filed under Haggis, and most people’s idea of orange juice – the basic one- litre cartons – is not listed along with the monstrously extravagant freshly- squeezed varieties that dwell in Juice Orange. It is only after several minutes of fumbling lateral thought that one chances upon Juice Pure Longlife. And although I eventually deduced that “B/e” denoted “Birds Eye”, this only partially satisfied my curiosity regarding “B/e Bakers Bis Vegetableprov Plaits 290g”.There is a search tool, but it is a somewhat over-zealous assistant.