Why does a visit to the gp leave us feeling so inadequate?

When 29 year old Real Life reader Anna went to her doctor with an emergency asthma attack, it was not a good experience.

The conversation, she recalled went like this. "'Oh yes, and when did you last have a cigarette, an hour ago?' I said, 'No, six months ago: He didn't apologise. He fused to believe me, or amend my notes. He made me feel like I should stop wasting his time. I don't see why I'm such a nuisance to him; I was actually told to make an appointment by the pharmacist It's not unreasonable for him to expect to see his patients occasionally"

Bad doctors are like penalty fares. We have all been wronged. We all still feel the pain of injustice. Me? I could tell you a few. Once I told a GP I was feeling low. This was translated in my notes as a "history of malaise". I almost didn't get life insurance because of being a suicide risk. Another time a young male doctor, when I told him I had not had a period for 18 months, said breezily. "Oh. come back in ten years and stop fussing'. At the time, I thought, "He's right, I am making a fuss: What a whinger" Only later, when I wrote about osteoporosis and its link with amenorrhoea did realise he was talking tosh.

Doctor and patient need different things. I need my doctor.to be interested in my health. She needs me out the door, prescription in hand, so she can get through the other 39 patients of the day. It's a stressful clash. Patients' Association Council Member Joyce Robbins suffers from what she calls "white coat hypertension". That is, she was being treated for high blood pressure with beta blockers, until she realised that her blood pressure was only high at the doctors - when it was taken at home it was perfectly normal.

"People are very vulnerable and the professional has all the confidence", she says, "so it's not surpnsing that patients don't always make best use of their time. The doctor is too busy staring at the notes or the computer screen to make eye contact."

The truth is that visiting the doctor's is a strictly business transaction. It's not their fault, but still, it's hard to take. I know I'm sentimental. but I. struggle to be entirely businesslike with someone looking at my bottom. I can't launch straight into my anxieties at 8.30 in the morning. I need a sympathetic nod. Some indication that the doctor doesn't think I'm completely stupid. Maybe I haven't got a brain tumour, but they don't know that. Sympathy can go a long way you know.

Of, course, if you go in expecting no more than you would from the person at the checkout then you won't be disappointed. Instead of hoping for a sympathetic listener, treat it like a supermarket trip. The best results come if you have a good list. "Write down what the problem is, what the symptoms are, how long you've had it, and what you think it might be," says Joyce Robins. "If you can give a concise explanation at the beginning, the doctor should see you are an intelligent, capable patient."

Once the medical problem is handled go see someone else for the sympathy. There will always be a need for complementary therapy while the average GP time is just four to eight minutes.

My placebo effect at the osteopaths is so strong, I start feeling better walking through the door. At the doctors the reverse is true. Sitting in the waiting room, I deteriorate rapidly. I might have brought my pocket Nietzche but I am soon reading; "My step sister removed my burst appendix in a car park with a crook lock", from. A magaaine published in 1988. No wonder the doctor thinks I'm an idiot; by the I get to her, I'm sounding like a woman's magazaine.

I felt anxious just ringing the Royal College of General Practitioners. I expected the receptionist to answer the phone and bark, "Well, have you got an appointment, then?". But they didn't, actually. They are concerned about doctor-patient relations too. Especially with the evidence that a happy patient in control is a patient who recovers quickly.

"Most patients are not particularly skilled at knowing the questions they need to ask," says PatricIa Wilkie, a psychologist and lay chairperson of the Patients' Liaison Group at the Royal CoIlege. "And they feel distressed when they don't know their doctor personally - which is a major cause of dissatisfaction too. You can sometimes have a more satisfactory relationship if you join a smaller practice, with a maximum of three doctors."

Doctors can also get defensive if you let them know you have worked out a likely prognosis for yourself. "There is such a huge amount of information," says Patricia Wilkie. "Patients can get so much more from the Internet, that when they try an make an informed suggestion, the doctor can get defensive. They can be patronising. They forget that if a person can fit a central heating system or fix a car, they might also be quite capable of understanding their own medical issues."

I guess it's hard for doctors too. They have to juggle budgets and hypochondriacs, patients getting aggressive, an endless queue of people wanting their undivided attention. Just like the checkout operator, in fact.

The Life Doctor, 12 July 1998, Independant On Sunday