Some years ago, when I was in a senior role at the RCGP, I was invited to an awards dinner at a large hotel in central London. After the usual pre-dinner mingling, I was led into the huge and impressive dining room and taken to a table where

I realised that I knew not a soul. I was also significantly older than every other guest.

After everyone had entered, our host for the evening asked us to sit down, and the starters were served. A young man on my right-hand side turned to me and said, ‘So, who are you then?’ I told him my name. ‘What do you do David?,’ he asked politely. I told him I was at the dinner because of my role at the Royal College of General Practitioners.

‘Can I ask you something?,’ he said. ‘Of course,’ I replied. He looked serious. ‘Well then, David,’ he said, ‘Could you tell me why GPs are so f***ing useless?’

All the other guests at the table had been stunned into silence and were waiting for my reply.

Remembering the importance of exploring ideas, concerns, and expectations – even when away from the consulting room – I asked him who he was, and why he and his colleagues were at the dinner.

‘We’re all here from a teenage cancer charity,’ he said, ‘and I’m pretty sure I’m not the only one who thinks GPs are f***ing useless.’

I asked him to explain. He told me that he had consulted his GP on several occasions before he had finally been referred and his tumour had been diagnosed.

I began to understand his feelings.

I asked the rest of my dining companions about their experiences. Some had been diagnosed very quickly. In other cases, there was no doubt that there had been a significant delay.

They all felt that GPs should refer their patients immediately to hospital if there was the slightest possibility of cancer. I could absolutely understand why they would feel this.

I asked about their initial symptoms, and in all the delayed cases the symptoms had been incredibly vague.

So, while totally sympathising with, and understanding, their predicament, I described my most recent surgery, carried out earlier that day. As I went through the cases in my mind, and in totally anonymised form for them,

I explained that many of the patients I had seen that day had symptoms that could possibly have been cancer.

If I had referred every one of them straightaway, the waiting list would become so long that it would adversely affect those who definitely needed to be referred.

Part of my job as a GP was to determine which cases did need referral, and which didn’t.

I tried to explain that this is an incredibly complex task, and that inevitably sometimes we didn’t get it right, and that we were constantly trying to work on ways of improving our diagnostic skills. However, referring everyone was not the answer.

We had a great evening. One of the most memorable I have ever had. They were totally delightful as a group, challenging but thoughtful, keen to learn and to understand, eager to share advice and suggestions. They were grateful that I had spent time sharing the complexity of the life of a GP, something that they, understandably, had never considered.

At the end of the evening, they even invited me along to their annual conference, though as this clashed with a holiday, I couldn’t join them.

Years later, I had a cancer which started with very vague symptoms too. The role of a GP certainly isn’t easy.