Doctor–patient relationships in primary care: Doctor, help! My child has cancer.

The following extracts are first, from an article by the mother of a child who had died of neuorblastoma. In it, she argued that her general practitioner, although generally supportive, should have taken more of the initiative in offering help during her child’s illness. Second, are extracts from her general practitioner’s response.

The parent A call for help may be an obvious one, from parents trying to come to terms with their child having cancer, or a hidden plea from parents outwardly coping with the demands thrust upon them, but who are inwardly desperately struggling. Are both these calls for help recognized and responded to by their family doctor? Our family doctor, contrary to my expectations, did not maintain contact with us during our son’s illness until the final stages. We were surprised and hurt by his attitude and mistakenly took his lack of contact as a lack of interest. Regular contact with us should have been an integral part of his role as our family doctor. Poor communication is the root of many problems – communication between treatment centre and general practitioner; between local hospitals and general practitioner; and between general practitioner and family.

The doctor At the base of these (contradictory thoughts and emotions) is the unique and multilayered relationship between general practitioner and patient, whether an individual or a family. We are still a long way from a satisfactory team approach to serious and terminal childhood illnesses . . .