The Medical Advice I Have Completely Ignored As A GP

Twelve years ago, when I was a junior doctor in training, my supervisor at the time sat me down to provide feedback on my work. Overall, he was happy with me, but he said one thing that has been burned into my memory ever since.

Don't ever admit to the patient that you don't know something.

He went on to talk about confidence and that you must always keep up the appearance that you know what you are doing and the doctor cannot admit to uncertainty....blah, blah, blah... I must admit, I zoned out a bit. Partly because I have ADHD and partly because he was - well - wrong.

The more I thought about it the angrier I felt. I proceeded to ignore that advice for the rest of my medical career.

If I had to pick one quality that I think is most dangerous in a health care worker it is this - arrogance.

Arrogance is a first-class ticket on the road to harming patients.

Humility is a virtue not often talked about anymore. It is often mistaken for timidness or weakness. It is not. As a doctor, humility is the ability to say I don't know. I'm not sure. I am not God. Medical science doesn't have all the answers and doesn't always get it right.

I have now switched seats and am the supervisor. I currently have two registrars at the clinic who are fantastic doctors. Their level of knowledge is exceptional, and this keeps me on my toes. Just when I think I know the answer to something, they gently mention that the guidelines have changed since I sat my exams. How we manage a condition can be completely different only five years later. Knowledge is growing and shifting all the time. Doctors must accept that our current, gold-standard, evidence-based care may well be obsolete one day.

Twenty years ago, as a medical student, I remember a particularly obnoxious gastroenterologist giving us a tutorial on various gut conditions. He mentioned IBS (Irritable Bowel Syndrome) with a sneer and said (I am not kidding) - These women just need to be less stressed and eat better. There is nothing really wrong with them.

Fast forward to present day, where we now have a vast amount of research into IBS. We know that certain dietary triggers can exacerbate symptoms and that avoiding trigger foods helps. He have programs for gut hypotherapy. We know about healthy gut flora and the brain=gut connection. We are slowly learning more about the links between IBS and neurodiversity. Arrogance in medicine makes you look really stupid a few years later.

If a healthcare worker ever uses language like 'You must...' or 'This definitely will cause...' or 'This is your only option' - run for the hills.

I will never stop admitting when I don't know something or when Western medicine doesn't have a good answer yet. But at the same time, I promise I will always do my best to work through it. I will keep researching. I will find a good specialist in that area. I will let you know when new information or treatment emerges. I will study and upskill and improve.

One thing I will never do is lie. If I have to pretend to always know everything in order for patients to have confidence in me, then it is probably time to find another career.

Our registrars are getting a very different message to what I had twelve years ago. Hopefully I'm not too much of an old dinosaur yet. I want them to reach fellowship with this bit of advice - Don't ever be afraid to admit when you don't know something, just commit yourself to doing your best to work it out together with your patient.

This blog is a side passion of mine, but if you are looking for my website for Breastfeeding and Sleep Support, you will find it at drdeborahcarrington.com