I did nearly 2 years of psychiatry before starting my life in general practice, and boy, does it ever come in handy sometimes. Some surgeries resemble psychiatric out patient clinics more than anything else sometimes, and such was the case today.
The first one was a chap who has been in to see the doctors no less than 7 times in the last 2 months, which I'd like to tell you is a record, though it isn't. After about the third time I gave up and referred him to the local psychiatric clinic- the CMHT, not that they will help him much. They'll decide he has "one of the spectrum of anxiety disorders" and probably give him anti-depressants. What they won't do is give him what he wants, namely CBT (cognitive behavioural therapy) because that is very difficult, if not impossible, to get on the NHS. And still he comes in with his insomnia, abdo pains and continual nausea. As he is seeing the CMHT on Thursday I decided (to his consternation) not to intervene ahead of them.
Later, out of 39 patients seen today, about 11 others had specific neurotic-type symptomatology, Hey ho...
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