Epic doctor rant: So you “just want a doctors letter”? Well no…


Our physicians spend over 45,000 hours on SERMO.  That’s a lot of time for consulting on patient cases, discussing the latest medical news, goofing off…and venting.  One of our most exhausted UK-based GPs decided to put together a few form letters for the community this month to use when at their wit’s end.  We hope you enjoy this doctor rant as much as we did. 

What templates would you add?


Over the years, I have paid medicine a price – no sleep, lack of time with my family, an inability to be shocked by anything I am told, and a major wine bill. (Oh, and the dubious pleasure of watching 12 – count them – secretaries of state for health come and go).  So, I’ve decided to give something back. As a free service, I’ve written the “Tired GP Standard Pro Forma Letters” that can be used and adapted as required. I hope they are handy. In no particular order they are…

  1. To the homeopath. Dear homeopath; Thankyou for asking me to confirm that Mrs Trellis is fit to have homeopathy. The last time I looked she was able to drink tap water, so yes she is. However, in my opinion, anyone paying you a small fortune to drink water in the hope it has miraculous healing and memory properties, and who believes that homeopathy is not actually anything other than complete and utter hogs testicles is, at the very least, mentally unwell and so lacks both insight and capacity. This letter is costing you £50. Yours, Dr TGP
  2. To the spinal surgeon. Thank you for asking me to arrange an MRI scan on this man’s back, following my referral to you asking you to do this. The reason I sent him to you is because I do not have direct access to MRIs – GPs are not worthy enough apparently – which is why I actually sent him to you. If you could be bothered to get off your backside in your outpatient clinic and walk round to the MRI department 10 yards away to arrange it, that would be helpful to both me and the patient. Good to know that your expertise involves sending a patient away from the person who can arrange what he needs to someone who can’t.
  3. To the optician. Dear optician; No – my patient does not have diabetes, high blood pressure, or raised cholesterol levels. How do I know? Because I measure them. You ought to try it some time.
  4. To the gym. Dear gym; I know you want me to say that Miss Bendy is fit to join the gym so that if she collapses due to too much aquaspinnaerobicyoga-ness, your arse won’t be on the line, but I won’t. Do your job. Unless you want a note that says that I can confirm that I’m unaware of not knowing any reason why she shouldn’t avoid exercise. By the time you’ve worked that out she’ll have got bored and taken up smoking. Go away. Dr TGP
  5. To the hospital junior doctor writing patient discharge letters. Dear wet-behind-the-ears junior. First of all, do try to write the letter in the same year the patient has been discharged. Secondly, I don’t read ‘GP to-do’ lists. If I did, all my time would be spent doing the bloody jobs that you should do but can’t be arsed to, and so wouldn’t have time to see my daily 50 patients, six visits, 18 telephone consultations, 3 hours of admin and two useless meetings each day. Unless you want to. Oh, I forgot – you leave at 5. Sorry. Fraternally yours, Dr TGP.
  6. To the even more junior hospital doctor. No, I will not ‘chase up this patient’s results’. You ordered them, so you do it. You married your wife but you don’t ask me to come round and sleep with her because you can’t be bothered to. Well, not yet anyway. Go away and stay gone.
  7. To the locum pharmacist. Dear pharmacist. Thankyou for scaring the Holy Hell out of my patient who I’ve been treating for 30 years by telling her that the NSAIDs she’s taking are about to give her a heart attack. I know that, but on balance of risk she needs them. You suggested I talk this over with her. What do you think I’ve been doing for the last few decades? Go and sell some useless cough mixture somewhere else.
  8. To the referral letter screener. No I will not tell you what my patients Oxford knee score is. If I have referred them for a total knee replacement, it’s because they have ground to a halt, no painkillers work anymore and they spend their days trying not to walk because it hurts so much. Take a wild guess what their score is. Now halve it and just arrange the bloody appointment.

And if anyone reading this has taken offence, I’m sorry. No, hang on that’s not right. That should read I’m sorry but I can’t be bothered to write another eight templates, this time less restrained.  I’m knackered and another day of firefighting in the NHS awaits.



If you are an M.D. or D.O. in the US or UK, please join us on SERMO.

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