Three generations have been looked after by the NHS and some folk have been disenabled to the extent that they expect the doctor or nurse to look after every mild illness. There are young mums who ring the doctor to see whether they should give Calpol to a child with a temperature; adults who think that a verruca warrants an emergency appointment on the same day, and one young man who put in an urgent request for the morning after pill before he went out on his “big date”( the age of chivalry isn’t dead). If there are fewer appointments available we need to use these more wisely. It’s worth pointing out that the majority of patients do a very good job at looking after themselves, only accessing NHS services when necessary. A minority of patients use up a huge proportion of the service in General Practice and in Emergency Departments with repeat attendances for trivial issues. I had a call recently from a very frustrated emergency department doctor to ask if we could do more for a young adult who had at that stage attended the emergency department more than 100 times. The doctor was taken aback when I advised them that the same patient had more than 6,000 contacts with my practice. So as not to leave this as a griping session, what do the smart patients do to help themselves and their practice? If you have children, make sure that you have a working thermometer and you should have paracetamol liquid and ibuprofen liquid available at home. If a child has a minor illness but no temperature, is eating and drinking and is running about as usual it probably doesn’t need seen by the doctor. If you suffer from blood pressure, it would be wise to get your own BP monitor as treatment room services are overwhelmed at present. These are inexpensive, accurate and easy to use and you can make a list of readings and leave it into your GP for comment. A lot of experienced patients now ring and tell me their temperature, pulse, oxygen (pulse oximeters available in pharmacies) and BP readings and ask for advice because they really don’t want to come out and sit next to a coughing child in a queue in the doctors. Some patients have gone very high-tech with smart watches and ring me up with their diagnosis of atrial fibrillation (a serious heart palpitation) and email me their rhythm strip which I forward on to cardiology at the hospital. I fully appreciate that in the future everyone will have this technology at home and it will be fed into artificial intelligence for a diagnosis and management. This may make me redundant which is fine by me as long as I’m not forced to play golf in retirement.