Daisy the Doctor, Dr Dose, Dr Grizzly, Dr Amelia Bedelia, and colleagues

The doctors' looks

There are three common features to the doctors' appearance: a white coat, a stethoscope, and a permanent smile. Only two doctors do not wear a white coat. One third of coats have pens sticking out of the pocket, and one is usually red. All doctors appear with a stethoscope, and most carry it all the time. Doctors are smiling in 126 out of the 154 pictures, even when they are performing examinations or talking. We attempted to examine each other's ears while smiling for a prolonged period of time and found it rather uncomfortable.

Twelve doctors are female, including two bears (Dr Bear and Dr Grizzly), and nine are male, including Dr Potts the dog. Of the humans, all but three are white.

None of the female doctors has hair long enough to touch their shoulders, and only two of the female doctors are blonde. We consider it inappropriate to comment on this fact. Clothes are very conservative. Only one male doctor does not wear a tie, and most female doctors wear flat shoes and skirts just below the knee. One third wear glasses, a high proportion compared with just two out of the 58 patients pictured. Most doctors look young, and only three might be middle aged. One general practitioner wears an indirect mirror on her forehead throughout the whole story but never uses it.

The doctors' role

Most doctors in these books are general practitioners, the others being an occupational health doctor, two emergency medicine physicians, one anaesthetist, and two surgeons. In one story the doctor is initially a general practitioner but then acts as a radiologist and subsequently a surgeon. We assume this is a “hospital at night scheme.”

All the doctors seemed busy. Their hands are never at rest or they just hold an object such as a clipboard. One of the doctors complains that she saw 15 patients in 2 hours 20 minutes. We feel that a clinic of that size should be manageable provided that all cases are simple. They spend a long time talking to the patients and playing with the small children. They often allow the children to play with the instruments.

The doctors perform jobs that are traditionally done by other healthcare workers. They carry out seven paediatric check ups, involving weighing and measuring the children. They give the injections in five out of six immunisations. We assume that the nurses were probably on their break.

The doctors are generally appreciated by their patients. One gets a thank you card and another a present of ice cream. The patients all seem pleased about the service, and there are several mentions about the doctor being “friendly” and “nice.” Most patients leave with a smile.

The doctors' tools

Stethoscope—This is a permanent feature, and it appears in 125 of the total images. It is surprising to find that two thirds of the doctors carry it with the rigid arms around the neck. We assessed how plausible this might be. The earpieces pressed into the back of the head, the pressure over both carotids made us feel dizzy, and the distal end kept hitting the genitals. There is a great variety in the looks of the stethoscope. Some of them are quite unusual. Stethoscopes are used on 16 patients but applied only once on each of them. The places are variable: the axilla (three), shoulder (three), or the epigastrium (two).

Auriscope—This is popular too. It is used 10 times for both ears and eyes. On six occasions the auriscope is used as a torch to look at the throat and on two occasions the earpiece is still attached to it. This would result in an illuminated area of 4 mm². When the auriscope is used it barely touches the ear, and in only one illustration does the doctor pull the ear back.

Tongue depressor—Doctors examining the patients' throats use a tongue depressor and a light but the doctors' eyes always appear much higher than the children's mouths, making a successful examination unlikely.

Thermometer—This is seen nine times. All are mercury and glass. We are concerned about health and safety issues.

X rays—We see a few examples. Interestingly one shows a foot next to a banana and another proves that “the child was brave inside.” We are unaware of these advanced techniques.

The doctors' office

We see a total of 12 waiting rooms; only five look child friendly. The rest are crowded and dull. Patients waiting look upset or worried. At the general practitioner's, the staff is reduced to four nurses and three receptionists. Their attitude is always helpful. Unlike reality, the nurses' role seems to be limited to following the doctors' instructions. The desks display different items; the most common are telephones and tins with pens or tongue depressors. There are two family pictures.

Only two doctors have computers. These surgeries are in obvious need of some modernisation. Half of the offices have a framed picture that looks like a medical certificate.

The doctors' skills

The doctors' managerial skills seem good. There is no indication of waiting times. Seven of the stories start at home, and all patients seem to get an appointment immediately. The general practitioners deal with various minor complaints such as colds and coughs, minor trauma, skin problems, one fractured shell of a tortoise, and check ups.

The doctors do not hesitate in their diagnosis. In terms of treatment, six patients with colds, coughs, or sore throats receive a prescription for “medicine”; a child with earache gets a prescription for “antibiotics and painkillers.” Half of all patients leave with a prescription; this seems high for such minor complaints.

The occupational heath doctor checks the hearts of three people (a fireman, a police woman, and a builder) during Healthy Heart Day. She describes the noises she can hear (“ba-doum, ba-doum”) as a “very healthy heart.” We believe this assessment to be appropriate.

We are concerned about the ALS (advanced life support) skills of the hospital doctors. Two patients on monitors seem to be in ventricular tachycardia or ventricular fibrillation, but they receive no special attention. It could be a technical problem, however, considering that the patients don't look clinically compromised.

In general, examination skills are variable. Most doctors seem highly incompetent during ear, nose, and throat (see above) and abdominal examinations. Three doctors feel abdomens with the tips of their fingers (as if playing the piano).