The customer in the travel agent’s might not have known what she wanted, but she certainly knew what she did not want.
She dismissed place after place as too warm, too cold, too expensive, too cheap (and therefore probably full of yobs), too far away – and too recent, in that she had been there before. In a surprisingly short period of time, she settled on a villa in Portugal for herself and himself, paid the deposit and left.
I was next up.When I jokingly remarked that the previous lady had known her own mind, the travel agent, to my surprise simply said: “She’s great. She is honest, and we love honesty.”
A travel agent is very like a family doctor .We both encounter people who want guidance, who have a notion what they want, and are unsure how to achieve it. But travel agents also have a great advantage over a GP: They can book the punters in from their computer instead of having to write a letter to an airline explaining why the client really, really needs a break, so holidays must be more important than health in the modern world.
Common bond
The concept that we GPs share a further bond with our friendly travel agents – an appreciation of the honesty or the lack of it – set me thinking.
The longer you practise medicine, the less surprised you are by anything. In the first year or two on the job you get over the shock that patients do not take their tablets, or do not tell you they smoke, or that they had not really fallen in the supermarket,.
The outright liars are easy enough.They are usually seen in the context of requests for sickness certs or sleeping tablets. The ones who fool themselves are trickier. They often start with a long preamble about how they don’t like taking antibiotics, for instance.
The “but “is implied rather than spoken. You usually, after a good look, agree that antibiotics would not be helpful, and find yourself in the middle of an argument about why an antibiotic is needed after all.
The next patient in is far worse than you expected when you saw him a few days ago, but he is unlikely to tell you that he did not take the tablets which you prescribed him then because he had no faith in them.
A bit of honesty would have helped, but he just pocketed the prescription and complained about you to everyone in the pub, who despite the fact that they think you are great, agreed with him for the sake of conversation.
"What do you honestly think yourself, Doctor?" is a sometimes a difficult question to answer. I thought Hilary Clinton would become US president up to the wire,so what do I know?
Then again, doctors have to be aware of the Leicester City scenario. For those who don't know, Leicester City won the English Premier League in 2016 – a 5,000 to 1 shot. So even though your pain in the back could theoretically be much nastier, it's probably not. But come back to me if anything changes.
No scans
Making the decision without scans is known as "living with uncertainty", and making a plan in case things go wrong is known as "safety-netting" in Consultation Skills language. But to do these fairly difficult tasks well you need to have your facts right and hope that the patient is not holding back information, or even misleading you.
You also have to check yourself periodically.You do not want to scare the patient unnecessarily, nor do you want to give them false reassurance that everything is great any more than the travel agent wants you to land in a war zone.
Thankfully, the days when a doctor would smilingly tell a patient that everything is fine when they were terminally ill have gone,but I have seen plenty of examples where people were told that they would be recalled in a couple of months when a couple of years would have been more accurate.
So the poor travel agent puts up with punters who are really checking out a holiday to book online, or won’t come clean that they are allergic to camels, or don’t want to go at all but are just telling the wife that they were in and there was nothing suitable. And we GPs spend an inordinate amount of time trying to sift the truth from the waffle.
I saw that travel agent customer later on in a restaurant, sending back her lunch, and I found that I had totally changed my opinion of her. She can join my practice any time.
Muiris Houston is away