I am a GP. I know a fair bit about colds. I have uttered the famous words ‘This seems to be a viral infection, it will get better on its own, you don’t need antibiotics, just keep hydrated, take some paracetamol, and if things aren’t settling or if they’re getting any worse, come back and see me again’ more times than I can remember. I have watched as the medical media tries desperately to educate the general public as to when they don’t need to see a doctor while simultaneously telling them that they must see a doctor immediately because they might have cancer.
Last week, I was struck down with a cold. I can say that now, with the magic and wonder of hindsight, but when I was in the throes of my war against mucus I found myself questioning how something so minor could feel so horrendous.
It started with a sore throat. During the first 24 hours I looked in my throat (with the aid of a mirror, my phone and 11 years of intense medical training) 12 times, each time more certain that I would find a horrific tonsillitis. It wasn’t even red. I checked my temperature eight times, with increasing dismay as to how it could possibly be normal.
The second day the sore throat had miraculously resolved, and had made way for a dry tickly cough. Horror of horrors, I thought, thinking of all the times I have said: ‘After a viral infection you can get a dry cough that can last up to six weeks.’ Six weeks? How would I cope?
It resolved about three days later, but not without me scaling the entire spectrum of suspicion as to my actual diagnosis.
Of course I embellish, but I am an actual doctor — if I wasn’t, who knows at what point I would have decided that I could take no more and called my GP. I think it’s very easy for doctors to forget what it is like to be patients, and this can result in people thinking we are unsympathetic.
With the current situation of GP practices — and the NHS as a whole being understaffed, underfunded and overstretched — we have little choice but to encourage people to have a greater awareness of what constitutes a minor self-limiting illness, thereby reducing ‘unnecessary’ appointments.
This of course throws up the debate about what is necessary or unnecessary, as arguably a huge part of the role of a GP is to provide reassurance that nothing serious is wrong.
So how do we balance preventing misplaced demand on the service with making sure that it is, in fact, just a cold? Mass generic advice is tricky — for every worrier there is a stoic who will have to be at death’s door before even considering that they may be unwell enough to see a doctor.
I suppose that, as in most cases, the answer lies in being reasonable. Not booking an emergency appointment (or going to A&E) at the first sign of a sniffle, but watching and waiting for a few days to see how it pans out. Seeking advice and over-the-counter supportive treatment from the pharmacist. Educating ourselves (or even being educated at school, which would be amazing) about basic self-care, and the difference between symptoms of simple viral illnesses and other types of infection. The NHS Choices website has some great information about this.
Of course, there will always be exceptions to the rule, and often telephone advice can be sought through the GP or 111 (although the pressure not to miss more serious problems can result in somewhat defensive advice). Ultimately, however, it would be unrealistic to expect people to always be able to self-diagnose in these cases. The more we insist on this, the more we run the risk of missing more important diagnoses.
It is arguably still reasonable to see the GP if you are unsure. Whether it can wait until Monday or not is for another time.