The immediate thought that most of us have is that going to a doctor will reduce concern.
However, this is of course often not true.
Let us take a simple headache as an example.
In the town in which I lived, probably 100 people wake up each morning with a headache, and only1or 2 go to the doctor.
They usually, but not always, turn out to be the most concerned out of the 100.
The first is a woman of 25 who is afraid of her recurrent headaches, thinking she probably has a brain tumour.
She is hoping to be taken seriously and properly investigated and treated.
She has come today because it is particularly bad, and she had a row with her boy friend last night over a TV program about doctors misdiagnosing cancers.
The doctor is a bit rushed and does not discover all her fears but he does discover her fear of a brain tumour and see her immense relief at being allowed to talk about it.
He examines her thoroughly, including her fundi (the retina using an ophthalmoscope).
This is on the doctor's part, of course, intended to be both diagnostic and therapeutic.
After discussion, explanation, advice and the offer of a possible follow up appointment, she leaves with less concern than when she arrived.
Her health understanding has changed a little, but the change is brittle and it will not take much to bring her back.
Our second patient is a 56 year old Banker who says he is not too concerned about his recent onset of migraines because his mother got them at about this age, but he would like some of those new injections or something like that which he read about in the evening paper.
The doctor goes through a similar routine.
This time he notices something medically worrying, a nystagmus or twitch to the left and swelling of the left optic disc with a fuzzy right disc, these are signs of increased pressure in the brain, the doctor is anxious.
Our patient picks up on the doctor's concern, and the urgent need for neurological opinion raises his anxiety level considerably despite soothing but unconvincing blandishments from his doctor.
This is a comparatively rare event in family practice; most headaches are not caused by brain tumours.
This example is intended to illustrate the rather obvious point that concern can increase after a successful consultation with a doctor.
The effect that the doctor's style can have on our concerns is worth repeating.
Respected authoritarian physicians have the power to reduce anxiety at the cost of reducing our autonomy and this effect is sometimes short lived.
However, giving ill patients too much choice can raise anxiety.
This is a difficult equation for both doctor and patient and deserves your attention.
Sharing information and understanding with doctors would seem to be the best compromise as being most likely to increase your autonomy or ability to decide on your own best treatment while constraining any unnecessary increase in your concern.
There is a famous curve much beloved of psychologists that clearly demonstrates performance (which in this case means following medical advice) increases with our level of concern to a certain point and then plateaus and falls off.
This curve should interest doctors too.
If our anxiety, concern or fears are too great, we will not do what it is in our best interests to do.
This may be why showing cancerous lungs in bottles to smokers is not usually a very effective technique to help them give up.
It pushes the majority over the top of the curve.
Too great a fear of cancer freezes us into inertia, and usually stops us hearing too, whereas a small decrease in concern may put us on the peak of our likelihood to follow advice to the letter and enable us to face the rigours of the treatment.
This is a simple but very important curve.
Keep it in your mind.