Doctor, I feel slightly funny.

There's a theory that the real problem with the NHS is not too few doctors, but too many patients. Some politicians like to pin it on the fact that we've become a nation of accident-prone, alcoholic, smoking lard-buckets. If only we could all learn to eat, drink and be merry responsibly, then half the health budget wouldn't be frittered away on potentially preventable diseases. Sociologists prefer to blame the politicians for creating mass involuntary euthanasia in the UK. It's called living in the North of England. The rich live 10 years longer than the poor and the gap is widening under Labour. Until it narrows, no health service will ever cope.

An additional strain on the NHS is that it is full of patients who have little to gain from being there. The beauty of the NHS – that you can be scraped off the pavement without having to check for your Barclaycard – is also its weakness. Any service that is free at the front door encourages life's little problems to become medicalised. A GP friend was phoned at 3am by the relative of a man marching drunk down the high street with his glass eye balanced on the end of his penis. It's a fine trick, and worthy of an audience, but it doesn't have to be a doctor.

Another GP has a T-shirt with "CAMERA" on it; the Campaign for Real Ailments. Much of his workload consists of defusing the anxiety of an increasingly worried well population who don't have any discernible disease, just an awareness of what might, or might not, be "risk factors". Alas, in the doomed pursuit of a risk-free life, their new health awareness makes them pathologically anxious and they end up on anti-depressants. Great for the drug industry, but not great medicine.

Within the humor one can often find wisdom. Our challenge remains sorting out the worried well from the sick. The most dangerous patient is the somaticizer. Sooner or later their complaints are real. Medicine is easier when you know something is wrong - perhaps that is one appeal of doing a subspecialty - someone out screens out all the complaints. But we must remember (after we stop laughing) that the complainers need us also. They need our relationship and validation. We often help patients without a prescription or a test. Unfortunately, we have no outcome measures to document it - and the bureaurcracy probably does not want to pay for that help.