Table 44 The doctors personal factors that influence communication

Age Sex Senses Handicap



Elderly, young Opposite

Deafness, speech idiosyncrasy

Health understanding Professional training Social awareness Empathy

Bias—patient attending other doctors or alternative practitioners

Religion, sexual practices Social class Ethnic group Communication style differences Political group


Eccentricities Familiarity

Furthermore, there are many strategies, roles, 'games' or 'hobby-horses' that some of us appear to rely on, especially when confronted with difficult or threatening circumstances, such as the management of the terminally ill.

Dare we recognise in ourselves some of the following unkind caricatures of doctors, i.e. personality types who may generate unfavourable communication? 7 8

Dr Al Oof (Fig. 4.3). The prima donna doctor (not necessarily a surgeon); aloof; omnipotent; dark suit with matching Mercedes; club tie or bow-tie; feared by medical students; partial to Scotch; pronounces certain cures; powerfully dispels doubts; no faith in the healing process before surgery but unshakeable faith after surgery; unavailable in the patient's decline.

Fig. 4.3 Dr Al Oof

Dr N. Zyme (Fig. 4.4). The scientific doctor; machine-like; cool; assured; obsessive; drives an Italian car; orders a new test and drug at every visit; conversant with the cellular biochemistry of the disease process but ignorant of its host.

Dr G. Rumble. The gruff doctor; grunts in mono-syllables; brilliant but appears tough and unapproachable; actually quite shy, soft and kind behind the facade; drives a Ford.

Dr No Komento (Fig. 4.5). The secretive doctor; strong and silent, or is he weak and silent, threatened? In another world! Drives a BMW; a computer buff.

Fig. 4.5 Dr No Komento

Dr I. Knowall (Fig. 4.6). Glib; assured; garrulous; drives latest red sports car; drapes stethoscope around neck; accepts invitations to lecture on all subjects; rarely available on the phone; keeps patients waiting for hours.

Dr S. Winger. Modern, swinging and trendy; superficial; on first name terms with patients; drives beaten-up Renault held together by political stickers; works only 35 hours a week; cavalier; undiplomatically blunt.

DrX. Cytabull. Fanatic; madly enthusiastic about rarities; overreacts to physical abnormalities; compulsive writer to medical editors; refers patients ad nauseam; drives yellow Porsche.

Dr Genghis M. Pyre. Longs for a mega-practice, assistants (not partners) and a pathology service; addicted to conferences and cocktail parties; also yearns for a Daimler, a halo and New Year's honours.

Dr Buzz Bee. Ever busy; flits from one consulting room to another; frequent phone user during consultation; creates a sense of urgency everywhere; charming to patients but intimidates them; overservices; holds pilot's licence; drives Landcruiser when licence not suspended.

Dr Go Along Cassidy. Feels comfortable when he is giving patients what they ask for; has a 'conveyor belt' type practice; rarely leaves his chair and doesn't examine his patients; drives a Colt.

Dr I. Kling. Protective and possessive; hangs on to patients; refers only under pressure; overconfident; likes to be liked; indifferent medical record system; compulsive drug prescriber; still drives 1969 Volvo.

Dr Nat Ure. Strong on 'alternatives'; pleasant chap; keen on Blackmore's publications and remedies; health shop (run by spouse) next door for fibre, sprouts and vitamin pills; attracts an attractive clientele; mutters audibly while writing the rare script; into massage, yoga and transcendental meditation; wears a knitted tie; rides a bicycle.

Dr Fi Mayle. The invisible doctor; juggles patients, children and the PC with one hand while cooking dinner with the other; earns less, pays more; shuns cocktail parties in preference to continuing medical education (CME) meetings with child care; prefers to be really achieving something through her division rather than waiting for the power boys to do it for her; finds continuing care and collegiate relationships difficult; drives whatever will take her reliably from A to B many times a day. 9 (reprinted with permission)

Dr Amy Preschool. Ever late to start surgery; smartly dressed in three-year-old fashions (bought before the baby was born) bearing tell-tale infant food stains; babysitting problems; caring of mums and kids; constant attender of paediatric continuing education programs to find the cause of her child's continual diarrhoea; drives a late model Japanese-built station-wagon with a recommended car seat in the back. 10

Dr Family Practice. The conservative doctor; married to a university sweetheart; practising from home for many years with her husband; prescribes mist magnesium trisilicate for peptic ulceration, Relaxa-Tabs for panic states and the 'Red tonic' for depression; children grown up and at university; both left at home with the ageing parents, two dogs and two cars; she drives the Austin A30. 10

Dr Susie Nirvana. Pap smear queen; always working, never in the same place twice; takes her entourage of similar searching patients with her. Drives someone else's car. 10

Dr Magoo. Always in court; popular with solicitors; never examines patients; great conversationalist; rarely looks; misses obvious signs; can't afford a car.

Dr Ann Osmia. Socialite doctor with 'special' clientele; senseless to sensory signs such as abnormal smells, sights and sounds; has difficulty with diagnosing alcohol abuse, gastrointestinal disorders and diabetes; harbours secret bad experiences with neurology tutor; drives a Saab cabriolet with matching poodle.

Dr Otto Sclerosis. The clinic's unpopular doctor; doesn't listen; doesn't hear; preoccupied; has gambling and drinking problem; drives Range Rover when driver's licence not suspended.

These caricatures mirror something of ourselves, so that, it is to be hoped, we can understand our own attitudes and behaviour. The stereotypes portrayed may well adversely affect our relationship with our patients and colleagues.

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