What does it take to be a good GP ?

This morning was very busy for me at my clinic. I had been away for a month except for weekends in the past month .

I think perhaps I should go away more often because it makes me relish the busy- ness.
If I were in a government clinic and earned my pay no matter how many patients I did or did not see, perhaps I would be less than happy to be having such a hectic time.

Anyway I am writing this because I needed to tell someone about a lady I saw.
She was about 5 months pregnant and she said she was having a liquid discharge , she had seen a OBGYN who said she was leaking her liquor and she put her on antibiotics AND DID NOT DO a Vaginal Examination.
I did a scan and saw almost no liquor. I looked for the foetal heart . It was beating regularly and strongly! I wanted to do a VE but the lady seemed scared and I had almost put away the VE set when the husband said there was a bluish stringy something that came out from the vagina. I did not see it. I put my hand in and felt it. So I did a speculum examination and found to my horror it was the umbilical cord of the baby. Two bluish cords that looked like the curtain ropes you could buy from the drapers.

I called up a OBGYN friend who asked me to send for an ambulance and ask for a Obstetric Flying Squad from Hospital Melaka.

I did phone , only to get a bored sounding nurse who was not too enthusiastic with my request and asked me to phone the A&E department .

I then tried to phone the Masjid Tanah health center and then the Alor Gajah Hospital and for some reason , no one answered the phone. So my staff called 999 and asked for an ambulance .

That worked!

An hour later a nurse came and half an hour after that the ambulance came . End of Drama in my clinic but not the end of the hectic time with patients.

A young man whom I had been treating for allergic rhinitis and asthma using Homeopathy had now brought his brother. He came all the way from Johor so I had not insisted he come back later because I do not like to mix seeing my CAM cases along with my regular cases. He had wanted his 13 year old brother to get homeopathic treatment for a condition that was there for a long time, perhaps since birth . He had to strain at urine.
I am glad I did not have the GP fatigue of taking for granted it had to be treated with medication.
I examined and found a pinhole meatus with hypospadius.

My question to myself and to you..How come he had not been seen earlier and the problem resolved via surgery ?

I put to you that what it takes to be able to help patients is an attitude :

Examine examine examine ......................

When in doubt over what to do , ask ........................or google .................................

No matter how fatigued and dulled your senses are because of work overload or....
sheer boredom over routine


This advise I give to myself .........for I must have been guilty of having missed cases like these two in the past .......


Hana and Aimi take note of what your Mum wrote and I am sure you two third generation future doctors in the family will remain conscientious no matter how big your workload and how hectic your day.....

ps click on the links to learn more ..the text in mauve