Saying goodbye to patients: a GP’s perspective

I’ve spent the last few weeks saying goodbye to my patients, letting them know, that after eight years, I will no longer be their GP. I don’t tell every patient I see, but instead restrict myself to telling those with whose care I’ve been more intimately involved in and those whom I’m advising to come back for follow up, knowing full well that I won’t be around to provide it. It needs to be done and I want to be the one to do it, but- as any GP could tell you- it hasn’t been easy.

On average, one or two patients per surgery, in response to my news, are so kind and generous or (about once every surgery) start to cry, that it is now a rare surgery that I come through with totally dry eyes. I have two more weeks to go and although I’m getting more able to cope with my own and my patients emotions I have to admit that I will now be glad when I’ve done all my news breaking. All of which, I suspect, will either ring true or sound more than a little overplayed, depending on exactly what sort of relationship you have with either your patients or your doctor.

In trying to explain to my non-medical husband what it’s like to say goodbye to a patient you’ve cared for over many years the best analogy I could come up with was this: I said it was like having to tell a member of your family that you couldn’t see them anymore. And this reminded me of how John Berger described the relationship between family doctors and their patients.

Berger said that the doctor becomes an honorary member of the patient’s family, allowed access to both the patient’s body and their inner world in a way that only family members are usually given. He reminded us that we are only given this status of honorary family member because in return we offer patients our skills and knowledge, and the promise that we will honour our professional commitment to do our very best for them.

Soon I will have new patients and they a new doctor. Over time I hope to earn their trust, to be invited in. But I will always have a place in my heart for the families I’ve left behind who for eight special years allowed me the privilege of being an honorary member.

  • Trevor Thompson

    Deborah – thanks for sharing your goodbying. Because I have followed an academic path (and a wife) around the country I have also had to say a lot of goodbyes. As well as the sorts of experiences you describes there are at least two other things I have noticed.

    Firstly there are some patients that saying goodbye to is a truly joyous event. To this day I celebrate the fact that I am never going to have to consult again with one particularly unspeakable manipulative help-denier. Forgive me.

    The other thing I noted is that some patients, rather than being sad are angry. They feel they have invested something in me. Felt that I would be around for a long time. Then I disappear leaving them bereft of the person that understood. This feels to them a betrayal. In some senses it is. I’ve put my career first.

    Honorary family membership is as complex as many families!