Dr John Smith: Can’t a doctor be a friend to patients too?

Do doctors know their patients as well as they used to, asks Dr John Smith
Do doctors know their patients as well as they used to, asks Dr John Smith

A quick walk around the town became a slow one as I met people who I hadn’t seen for years.

It was, in fact, at least 20 years because it is that long ago that I moved from general practice to Cransley Hospice.

Like many old friendships the years disappeared and it was almost like yesterday when I last saw them in my consulting room or in their home.

If I racked my brains I could probably remember what had been wrong with them.

But it is as people that I remembered them. Their jobs, their homes, their families, their interests, all flooded back.

I had gone through moments of great joy and times of sadness and despair with them. Whate ver their illnesses were fitted into the jigsaw of their lives.

Sometimes they only had to walk into the room and I knew something was wrong or if there was something to rejoice about.

I do not think there was anything exceptional about the way I worked. I was simply part of something extraordinary.

I was a family doctor with a personal relationship with my patients. I, like many doctors, knew the story of my patients’ lives.

There was no need to begin at the beginning, each consultation was like another chapter in a book. It was a mutually trusting relationship.

Time has passed and in the past 20 years there have been countless NHS reforms.

As we grow older and older disease becomes more complex – in 1964 when I started at medical school life expectancy was 65, now it is 79 for men and 83 for women – and this is making the work of the general practitioner much more complex.

The idea of the personal doctor is fast disappearing and the benefits that it brought are being lost.

We are living longer, we are for much of our lives healthier, so you may say the loss is worth the gain.

I am not so sure. Perhaps what I have described is a luxury that our country can no longer afford.

Perhaps we could have the best of both worlds – a professional skilled and competent doctor who is also a friend, or is that asking too much? I hope not.