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Good doctor, bad doctor—a psychodynamic approach

BMJ 2002; 325 doi: http://dx.doi.org/10.1136/bmj.325.7366.722 (Published 28 September 2002) Cite this as: BMJ 2002;325:722
  1. Jeremy Holmes, consultant psychiatrist/psychotherapist.
  1. North Devon District Hospital, Barnstaple, Devon

    Let's face it—we doctors aren't saints. Have we not all sometimes felt bored and irritated by certain patients, longing for the consultation to end? Can any doctor honestly say that he or she has never felt a flicker of sexual interest in a patient? Have we never—and post-Shipman it is very difficult to say this—imagined the death of certain patients and the relief that would bring, not just to them but to us, their impotent carers? Do we not at times resent the demands of people for whom illness seems to have become a way of life? Whose thoughts have not sometimes drifted off towards their own concerns—to the need for sleep, food, or distraction or to some family, career, or future plans?

    We are merely using our patients to bolster our own fragile sense of competence and health

    Moreover, perhaps rather than being motivated by altruism and scientific integrity, we are merely using our patients …

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