Hi Dr. Nick | Issue 01

Hi Dr. Nick | Issue 01

General specialists

Hi, everybody!

Something I’ve noticed in my travels through the healthcare system is that there are certain questions that come up whenever people find out you’re a medical student.

If you’re female, you’ll undoubtedly be asked: “Are you going to be a doctor or a nurse?” by your patients. If you’re male, you’ll undoubtedly be asked: “Can you have a look at this weird growth on my junk?” by your friends. If you’re transgender, gender-fluid or gender-queer, you’ll undoubtedly be asked: “How dare you exist in my world and confront my narrow-minded view of a binary-gendered society?” by idiots who deserve a swift kick to their cis-gendered genitals.

Irrespective of their crotch’s ability to dangle, however, there is one question that is asked of every medical student: “Are you going to be a specialist, or a GP?”

To ask this question suggests, like most New Zealanders, that the speaker doesn’t really understand what a GP is. You see, a General Practitioner is a specialist profession. They go to a specialist school, they get their specialist certificates, and they get to sit at the specialist table in the cafeteria with all the Orthopods and Anaesthesiologists. The thing is, GPs specialise in everything.

Now that may sound as antonymous as a St Margaret keg party or as impossible as somebody not from St Margaret’s understanding the word “antonymous,” but it’s true: a GP specialises in knowing everything in medicine.

Before you start calling the on-call proctologist to tell them that I’m full of shit, I’ll back up a bit. I’ll admit – that last statement was a bit of a lie. In my defense though, it was like an Englishman’s dick in an African locker room: little and white.
GPs don’t know everything in medicine; nobody does. No matter what their GPA, UMAT score or hall of residence, nobody has ever known everything in medicine. A GP’s job isn’t to try and know everything; it’s to know enough about every part of medicine so they can carry out a gatekeeping role. A GP has to be able to see a hundred patients with chest pain and work out which ones need a pat on the head and a push out the door, which ones need panadol, and which ones need to be panicked about.

A GP’s broad focus means that a cardiologist will always be more up-to-date with the latest research into the myocardial effects of sildenafil in Behcet’s Disease than them. But it also means they will be more up-to-date with the latest urological research than the cardiologist will ever be.

Like a haiku about a group of beautiful idiots, the bottom line is pretty simple, folks. GPs have a specialised role in the healthcare system: to be able to see a wide variety of things and be able to manage them all.

Don’t get me wrong – they’ll manage some things better than others. If you show up with conjunctivitis they’ll be more helpful than if you show up with von Hippel-Lindau Disease, but it’s pretty rare to show up to your GP with something they haven’t seen before or cannot help with. After all, they see hundreds of people with chest pain, hundreds of people with depression, and hundreds of people with weird growths on their junk.

Throughout its run, this column is going to tackle some of the big issues in health for students. No matter what it covers, though, it’ll never be a substitute for a good GP. So go find one that you can trust and make use of them if you’re concerned about anything health-wise this year.
This article first appeared in Issue 1, 2014.
Posted 6:57pm Sunday 23rd February 2014 by Dr. Nick.