It’s ironic that in the world of Dr Google and fake news, real doctors are increasingly called upon to justify their medical existence, writes Dr Dawn Oi
GP done and I’m entering the sweet old lady’s numbers into the computer when she gasps: “Where are your rings?”
I glance downwards on to the naked left ring finger in question tapping busily on the keyboard. It had been thus for about two years, since swelling in my fingers had forced me to lay my rings to rest in a drawer, and there they had remained.
The thoughts from my patients about my marital status had been far from my mind then. But not so now.
I assured her that I was still happily married, but ringless for practical reasons.
She looked relieved, I assume because she did not feel she had to enquire about my possibly acrimonious divorce.
Musing upon this later, I realised that behind the humdrum daily interface we have with patients as doctors there is a whole lot more going on.
Perhaps they are wondering about our untied shoelace, the remnant of toothpaste on one cheek, or, heavens forbid, our unwitting garlic breath from lunch.
Perhaps they are second guessing the choice of pink or blue of my daily scarf in winter, even in the all-round 23 degrees of the office. Would pink signify jollity in my mood, encouraging confidences from my patients? Or would blue signify a chilliness in the air, only encouraging routine CSTs, medication scripts and URTIs.
I should wear blue more often.
Of late, I feel I increasingly have been the subject of the third degree from youngish adult patients. In what feels a bit like an interview, I’ve been asked about my antecedents, my cultural background, and, most importantly, the source of my medical degree.
Reassured that I am not a graduate of the University of the Bahamas, but of a reputable Australian university, they proceed happily with the rest of the consultation.
It makes sense, naturally. Patients need to feel trust in their doctor, and to do that they usually need to check them out, size them up and “put them in a box”.
Of course, we do that with patients all the time. From the moment we call the patient in from the waiting room we’re assessing how they look, how they move, whether or not they look us in the eye.
First impressions and initial assessments are part and parcel of primary care, but then why do we cringe when we get the feeling that patients are turning the tables on us and doing their own categorisations?
Oddly enough, my most inquisitive interrogators tend to be “ethnics”, such as myself. No question appears out of bounds. Not only will I be asked about my country of birth, ethnicity, cultural background, schooling and university, but also where I live, my family and even the names of my children.
No wonder sometimes I feel that I am performing the medical version of Hannah Gadsby’s Nanette. Justifying my personal and medical existence, and all this before examining their child’s ear.
Does every doctor get these questions? Would these interrogations occur if I was Anglo and male? Or would a white older man be assumed to have been educated in Australia, hetero (but not guaranteed), and middle class?
Maybe I should hang up my framed medical degree. Perhaps to have it resplendent on the wall behind me would put paid to all these questions.
And then, to be absolutely certain, I should also display my citizenship certificate, marriage certificate and also the birth certificates of my children, to really ramp up my “believability quotient”.
Not for a moment do I mean to trivialise the importance of establishing trust in the general practice consulting room.
No doubt patients are looking to find facets of their doctor’s personality, lifestyle, history or character that they can respond positively to in developing rapport. Patients often need to identify with their doctor, especially if they are considering divulging very personal, private information such as domestic violence, sexual health problems or possible psychiatric symptoms.
Nonetheless, it is ironic that, in these days of Dr Google, when any random factoid that pops up on a search engine is given the status of gospel truth, that when a patient actually encounters a real-life doctor, the latter has to be put through the third-degree.
When the reverberations of a fake study on MMR causing autism is still causing shudders globally in the shape of misinformation and measles outbreaks, genuine doctors have to work 10 times as hard to convince patients of their believability.
Perhaps I should not be so precious about my personal life. Maybe I should not regard these queries as crossing some boundary.
Instead, I should consider them an indicator of the level of comfort and familiarity patients feel in my consulting room, as they settle themselves into the chair. Right next to the handy tissue box.
Maybe. But in the meantime, I might still get our handyman to put up my degrees.
And where did I put my rings again?
Dr Dawn Oi is a GP in metropolitan Melbourne who hones her skills by writing referral letters all day
