Intended for healthcare professionals

Views And Reviews Taking Stock

Rammya Mathew: The difference between a doctor and a family doctor

BMJ 2022; 376 doi: (Published 01 February 2022) Cite this as: BMJ 2022;376:o240
  1. Rammya Mathew, GP
  1. London
  1. rammya.mathew{at}
    Follow Rammya on Twitter: @RammyaMathew

My 1 year old daughter has been unwell for the past four days with diarrhoea and vomiting. She’s been struggling to keep any fluids down. I’ve naturally been worried about her and, as I write this, I’m wondering when I should get her seen by someone who can provide a more objective medical opinion. I’ve been holding back because she doesn’t look overly dehydrated, and although four days is longer than the expected course of viral gastroenteritis, it’s still most likely going to be that. She will, most likely, get better soon.

The slightly longer version of the story is that she started nursery last week and as a result had already been suffering from separation anxiety, so even before this bout of illness we hadn’t been getting much sleep at home. I also felt extraordinarily guilty about her having to spend 10 hour days in nursery since I started back at work in general practice. The fact that she’s become so unwell in her first week of nursery has only added to the guilt.

To top it off, I started a new job at the same time, so alongside the changes in our home life I’ve been trying to settle into a new role and get to know my new colleagues. Fortunately, I’ve had the support of my family, but the stress of having to organise childcare at the last minute and leave a sick child at home is not something to be dismissed.

When I was thinking about whether to take her to see our GP, it struck me that the difference between being a doctor and being someone’s family doctor is spending those extra minutes hearing the long story. Anyone could eyeball her, do a few basic observations, and pretty quickly conclude that she isn’t unwell enough to require hospital admission. But as family doctors we’re naturally curious and take an interest in our patients and their families. It’s the quality of these relationships, along with the trust that we build over time with our patients, that makes GPs unique and irreplaceable, giving validity to our counsel.

Anyone who still believes that general practice is just about coughs, colds, and viral illness is missing the bigger picture. We deal with complex disease, but more importantly we deal with the complexity of people, as well as the wider circumstances that influence their health and vice versa. GPs hold one of the few remaining pastoral roles that many people still routinely engage with in modern society, and it’s incredibly short sighted for anyone to undermine the role of the family doctor—be that through policy or put-downs. I think I now know who I’ll be calling in the morning.


  • Competing interests: None.

  • Provenance and peer review: Commissioned; not externally peer reviewed.

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