There’s nothing new here. Only my perspective. Literature, both professional and lay, is replete with the topic. I’ve even written on it  in the past. In this piece, I’ll be a bit more direct, with less satire (I hope).

In my annual birthday message, I intimated to my friends and relatives that I sustained multiple fractures (mid-shaft and distal intra-articular) of my left tibia. In amateur terms, I broke my left leg and ankle. Now Dorothy and Dick are asking, “Why didn’t you just say that in the first place, David?” Well, my parents paid huge sums of dough to send me to medical school. I have to use the jargon they paid for, Dorothy! Besides, why didn’t you also go to medical school, Dick? Huh?

Anyway…

A few months ago, I broke my left leg and ankle while in a delirious state. On that note, dear medical students, for all that is dear and holy, please master the difference between delirium and psychosis before you graduate. You might just save a life. A diagnosis of ‘psychosis’ in a delirious patient can have long-term ramifications that go beyond a consultation.

For my colleagues, I pose these academic questions: what is sleep deprivation more likely to cause, delirium or psychosis? In addition, what are the more likely adverse reactions of psychotropic (including narcoleptic) drugs, delirium,or psychosis? Lastly, if a patient presents to you with a proclivity to delirium from both sleep deprivation and psychotropic drugs meant to treat it, should their diagnosis be upgraded to recurrent psychosis, or, as the eager-beavers among us like calling it, ‘schizophrenia’? We’ll meet in academic circles.

Back to my piece…

Why I have not specialised yet

I’ve been inundated with this question time and again, usually through back-handed compliments. Invariably, it’s always, “Dr David, you seem like you’d make a good Specialist.” As if I’m not doing enough already. As if being a GP is not good enough. People just don’t get it. Ladies and gentlemen, please allow me to explain.

I’ve been waiting for a ‘Sarajevo moment’, a spark that ignites a life-long passion. It has finally arrived! I’ll not reveal it here. I know some of you. You loathe me and hate good things (wink).

In this part of the world, a medical doctor can practise as a General Practitioner or Family Doctor for as long as they want after completing their internship. That design is not pretty, but it’s pragmatic. It confers a bi-directional advantage.

The benefit to the doctor is that you take your time in deciding what you really want to do for the rest of your life. After all, that’s what being a ‘Specialist doctor’ is all about, concentrating on one aspect of a vast field for the rest of your life.

It’s not an easy decision, trust me.

For some doctors, especially those who love multiple fields equally (like me), it takes a long time to settle down. The greatest fear is getting bored doing the same thing over and over again every darn day, for the rest of your life. On the other hand, as a GP/Family Doctor, you can go through Paediatrics, General Surgery, Neurology, Gynaecology, Psychiatry, Obstetrics, and Internal Medicine IN A SINGLE DAY. It’s clinically and intellectually exciting!

From the other end, the benefit of our type of healthcare setup from a societal or organisational perspective is that the population is well served. After all, primary care (to which GPs and Family Medicine Specialists belong) is the pillar of medical systems globally.  

But that is only the major reason why I have not specialised yet: indecision. There are other minor reasons, of course. Financial constraints, lack of opportunity, etc.

Back to my experience as a patient…

What I learnt as a patient

There are a LOT of terrible doctors out there. There, I said it, in plain language. Last time, in ‘Going Undercover’, I was too diplomatic. This time, I’m too pissed off to be kind. Let me say it again. Some of my colleagues are HORRIBLE DOCTORS!

In fact, I suggest that every doctor should become a patient before being allowed to handle patients. I’m too winded, I’ll continue…