Many years ago, I had the pleasure of doing my pre-reg year in the West Country – the land of scrumpy, cheddar cheese, and 20-mile queues on the motorway to Cornwall. One thing I particularly loved was a folk band called The Wurzels.
Popular in the 1970s and 1980s, The Wurzels' songs had impenetrable titles such as ‘faggots is the stuff’, and equally unintelligible lyrics in songs like ‘thee’s gott’n where thee cassn’t back’n hassn’t’. However, my personal favourite was a song about not wanting to be burdened with other people’s troubles, called ‘don’t tell I, tell ‘ee’, and this could be an anthem for community pharmacy.
We all know how much of our time is spent telling people not to do something, such as “don’t ask the GP for antibiotics for your sore throat”, “don’t stick cotton buds in your ear”, or “don’t lean over the dispensary and bother the pharmacist unless you want to be jabbed in the eye with a pen”. But recently I’ve realised how much of my time is also taken up with patients telling us things that we really don’t need to know and truly can’t do anything about.
Firstly, there are patients who want to synchronise quantities of their drugs. They’ll bring a request slip, upon which might be written “ramipril x 27, aspirin x 12, atorvastatin x 33”, in the naïve belief that their GP has time to amend quantities so they have the same number of all their tablets. We try to point out they don’t buy 413ml of milk and 127g of sugar to ensure their food all runs out at the same time, but they don’t get it and feel the need to explain in detail the duration of every treatment in their possession.
Next are the dysphagic neurotics, who profess to be grown adults, but can’t swallow anything but “caplets” or “liquid”. They bring in a perfectly legible script for a sold oral dosage form that would easily pass the oesophagus of an eight-year-old, only to exclaim in amazement that it doesn’t state their desired option. They can’t get their head around the idea that they need to tell their GP, not me.
And increasingly inconsistent rationing of over-the-counter products on FP10 means there’s a constant queue of patients asking why their neighbour gets antihistamines and shower gel, yet while they can only tolerate an oat-based emollient, the GP is prescribing Cheapoderm…
Patients: want a specific brand of inhaler, or four months’ worth of drugs to visit your family abroad? Want to whinge about GP appointments, lack of ear-syringing, or your script not having arrived? Think the NHS-determined exemption categories unfair, or a manufacturer’s tablet foil impossible to get into?
Well we just haven’t got time. In the words of the late, great Wurzels’ frontman Adge Cutler – ‘don’t tell I, tell ‘ee!”