{"id":625,"date":"2013-06-23T12:20:19","date_gmt":"2013-06-23T11:20:19","guid":{"rendered":"https:\/\/blogs.bmj.com\/adc\/?p=625"},"modified":"2013-06-23T12:20:19","modified_gmt":"2013-06-23T11:20:19","slug":"engineering-irrelevance","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/adc\/2013\/06\/23\/engineering-irrelevance\/","title":{"rendered":"Engineering irrelevance"},"content":{"rendered":"

I have a favourite consultation. \u00a0Actually, I have a lot of favourite consultations, but this one is pretty high up there. \u00a0It happens every 18 to 24 months on average.<\/p>\n

 <\/p>\n

I will have met with a family, and we’ll have got to know each other on a journey (naff word, but can’t find one better) over a few years. \u00a0And, as these things happen, we reach that point where it’s the last time we meet.<\/p>\n

 <\/p>\n

We exchange a few words. \u00a0Very occasionally a card may exchange hands. \u00a0The family get up to leave. \u00a0The father – usually the father – has his hand on the handle of the consulting room door, is about to turn it to emerge back into the real world. \u00a0And there is a pause, and I think “It’s coming, my favourite bit is coming…” \u00a0Hand still on the doorknob, he turns and says:<\/p>\n

 <\/p>\n

“Don’t take this the wrong way doc, but I hope we never see you again”.<\/p><\/blockquote>\n

 <\/p>\n

And that’s it. \u00a0That for me is the pinnacle of my career. \u00a0There’s a hurried reassurance from me that, no, I don’t take it the wrong way. \u00a0There is more shaking of hands, and then they are gone, and I’m left with the feeling, which I store up in that good place I keep for when the bad stuff happens.<\/p>\n

 <\/p>\n

Medicine, practiced well, is the art of engineering your own irrelevance. \u00a0This requires a little explanation. \u00a0Consider two extremes: \u00a0Dependence and Independence. \u00a0As with the \u00a0Aristotlian Golden Mean\u00a0<\/a>\u00a0most of us wish for and achieve the middle in our relationships – interdependence. \u00a0What this means for me is that I hope that my family, friends and colleagues get a great deal from me, and if I were to exit their lives they would miss me, for my personality, for, well, me. \u00a0But I hope that the two extremes don’t happen: \u00a0I hope they neither completely fail to notice, nor fall apart.<\/p>\n

 <\/p>\n

It’s interesting that this works into management and leadership too. \u00a0We’re all familiar with the office despot who engineers things that when they go on leave for a couple of weeks things fail – nobody can work out the code for the photocopier, find the spare staples etc. \u00a0What the good manager, good leader needs is for people to miss them but not notice that much – “Oh, you’ve been on leave for a couple of weeks? \u00a0Great – did you have a good time?” \u00a0Obviously it does not escape me that this requires massive suppression of the ego. \u00a0Which brings me back to medicine.<\/p>\n

 <\/p>\n

Nobody wants a doctor in their life. \u00a0Actually, I’ll correct that. \u00a0The majority of straight thinking folk would prefer to avoid any contact with doctors (or other healthcare professionals for that matter). \u00a0With some people ongoing contact is necessary. \u00a0Many of us go into medicine in order to – in that clich\u00e9 of medical school interviews – to “help people”. \u00a0But actually, the bit when we’ve done our job the best is when people don’t need us any more. \u00a0They may still like us, we may still enjoy each other’s company, but we they don’t need us. \u00a0We’ve engineered our own irrelevance.<\/p>\n

 <\/p>\n

So, Bob, this is why, while I can understand your post<\/a> – and the specific needs of your patient group – I think it’s our job to make sure that folk don’t depend on us. \u00a0The success of this is the empty nest, and if we dread it, it should be for the freely acknowledged- and healthy -interdependence, and nothing more.<\/p>\n","protected":false},"excerpt":{"rendered":"

I have a favourite consultation. \u00a0Actually, I have a lot of favourite consultations, but this one is pretty high up there. \u00a0It happens every 18 to 24 months on average.   I will have met with a family, and we’ll have got to know each other on a journey (naff word, but can’t find one […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2681],"tags":[],"class_list":["post-625","post","type-post","status-publish","format-standard","hentry","category-practice-of-medicine"],"yoast_head":"\nEngineering irrelevance - ADC Online Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/adc\/2013\/06\/23\/engineering-irrelevance\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Engineering irrelevance - ADC Online Blog\" \/>\n<meta property=\"og:description\" content=\"I have a favourite consultation. \u00a0Actually, I have a lot of favourite consultations, but this one is pretty high up there. \u00a0It happens every 18 to 24 months on average.   I will have met with a family, and we’ll have got to know each other on a journey (naff word, but can’t find one [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/adc\/2013\/06\/23\/engineering-irrelevance\/\" \/>\n<meta property=\"og:site_name\" content=\"ADC Online Blog\" \/>\n<meta property=\"article:published_time\" content=\"2013-06-23T11:20:19+00:00\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Estimated reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2013\\\/06\\\/23\\\/engineering-irrelevance\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2013\\\/06\\\/23\\\/engineering-irrelevance\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"Engineering irrelevance\",\"datePublished\":\"2013-06-23T11:20:19+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2013\\\/06\\\/23\\\/engineering-irrelevance\\\/\"},\"wordCount\":620,\"commentCount\":1,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/#organization\"},\"articleSection\":[\"practice of medicine\"],\"inLanguage\":\"en-GB\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2013\\\/06\\\/23\\\/engineering-irrelevance\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2013\\\/06\\\/23\\\/engineering-irrelevance\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/adc\\\/2013\\\/06\\\/23\\\/engineering-irrelevance\\\/\",\"name\":\"Engineering irrelevance - 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