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Revalidate patients first

I’m writing this column with doc flu, which is even worse than man flu. And because I’m a man doc, it’s actually man doc flu, which is the worst of all. I know when I’ve got man doc flu, because patients say to me, 'you should see a doctor', an utterly hilarious joke for those with a pounding headache, a sandpaper throat and a bulging waiting room, particularly at the eighth time of hearing.

And I know why I’ve got it, too. It’s because, roughly the incubation period of a rhinovirus ago, a middle-aged man with a URTI coughed, long and hard, in my face. He made absolutely no attempt to turn away or cover his mouth; I could feel his catarrhal aerosol pepper my cheeks.

'You disgusting oik!' I exclaimed. 'That’s appalling. Have you really reached the age of 50 without learning any decency or manners? Don’t you know anything about personal hygiene? Can’t you keep your revolting germs to yourself? Next time, I hope it’s Ebola, you spittle-spraying troglodyte.'
Not out loud, obviously. After all, I’m not sure where the GMC stands on this. I’m dimly aware that it doesn’t like us insulting patients – but why should I let this phlegm machine scattergun his vile droplets everywhere, potentially causing doctors to be off sick and thereby compromising the care of other patients? Suck on that, duty ethicist.

Anyway, this is just the tip of an iceberg of declining patient standards. As I’m sure you’ll have noticed, the buggers just can’t be arsed about anything these days.

Take dress sense, for example. 'You’re worried about your earache?' I said, incredulously, to a patient the other day. 'Yet you’re unconcerned about wearing pleated trousers with turn-ups?' And personal grooming: 'So, you want treatment for your ingrowing toenail? Sure. But have you seen your hair?'

I could go on, so I will. Here are some other ways in which patients have let themselves go.

They turn up to my Saturday morning surgery in pyjamas. They drop litter in the corridor on the way to my consulting room. They come in still holding a conversation on their mobiles and they’re perfectly happy to take, and respond to, text messages during the consultation. They turn up 20 minutes after their appointment time and then try to justify it by pointing out that I always run late anyway. They think it’s acceptable to try to become my 'friend' on Facebook, and if you’d argue that this is hardly evidence of a drop in standards, I’d say it’s a drop in the standard distance we should safely put between ourselves and patients.

Oh, and they don’t always wear pants. Revolting.

Clearly, the punters need to up their game. If we GPs are supposed to respond appropriately to draconian scrutiny in an effort to raise standards, then so should they. So I propose that we revalidate patients every five years.

And forget about remedial training: those who don’t make it simply forfeit their right to any treatment, for anything, forever. Some would say that’s harsh. I say it’s evolution.

Dr Tony Copperfield is a GP in Essex. You can email him at tonycopperfield@hotmail.com and follow him on Twitter @DocCopperfield.