From The Frontline

Explaining the unexplainable

BMJ 2011; 342 doi: 10.1136/bmj.d1039 (Published 16 February 2011)
Cite this as: BMJ 2011;342:d1039

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  1. Des Spence, general practitioner, Glasgow
  1. destwo{at}yahoo.co.uk

As a white coated hospital doctor I had nursing support, blood test results, and radiology results for all patients. But when I started in general practice there were no nurses, no bloods, and no radiographs. Just me in a demob suit, a broken thermometer, and a stethoscope prop. I struggled to cope with 10 minute appointments as the list of possible differentials scrolled in my mind. I saw potential pathology in every consultation because everything was vague—neurology, chest pains, headaches, aches and pains, dizziness, bladder symptoms, and fatigue. The history never hung together and …

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