How not to be a doctor

Abstract

‘How can I help you?’ I asked. It isn't the way I always open consultations but I was making a teaching video, so I thought I would be conventional for a change. As it turned out, it was a fortunate move. ‘I’m not sure if you really can help me’, the patient answered. ‘I’ve seen lots of specialists, and none of them have managed to help me so far. You see, I keep having these funny turns …’ Two weeks later, when showing the video to a group of senior house officers, I stopped the recording at this point and asked them to write down the woman's presenting complaint. All ten of them wrote down ‘funny turns.’ They were wrong, of course. The woman's presenting problem was that she wasn't sure if I could really help her. The funny turns were at this point a lesser problem. There were more shocks in store for the group. I spent almost the entire consultation asking the woman about her experience of other doctors, and what they had got wrong. I listened as dispassionately as I could, without dismissing her catalogue of disappointment or offering any hint that I might …