When I was a teenager, I was obsessed with playing guitar. I taught myself to play on my sister’s guitar, taking it off her when she came back from lessons. For my GCSE music performance I sang and played an Eric Clapton song. While I was at medical school, I became obsessed with climbing after working in a children’s multi-activity centre one summer, where I also used to play the guitar every night in the bar with the staff after the children had gone to bed.
At one point, when I was doing some research, I worked part time as a climbing instructor and probably went to the climbing wall five nights a week, then on day trips to the Peak District at the weekend. I spent six weeks camping at the bottom of a cliff near Grenoble, climbing nearly every day and drove all the way to Spain on a crazy three week road trip to mark the Millennium.
The things I obsessed about then seemed incredibly important to me at the time. In retrospect, they were hobbies—they still are to some extent. However, nowadays I obsess about something different. When I am not working, my mind constantly wanders to the state of the NHS and the future of general practice. I obsess about it, write about it, debate about it, blog about it, worry about it, discuss it, dissect it, and ruminate on it.
The difference is that in 10 years’ time, I doubt whether I will consider the object of my obsession as unimportant, although I may have a healthier dose of perspective as a father, husband, and doctor. At times I think I may overdo it, for in the grand scheme of things—looking at the problems from a global perspective—the state of healthcare in this country is probably better than the vast majority of other countries, or the healthcare that is available to the vast majority of the world’s population. So perhaps my worries are not as important as I believe them to be. Even if efficiency savings and/or privatisation cause problems with healthcare in the UK, standards are unlikely to drop to those found in, for example, Africa.
Having said that, I do believe that the state of healthcare in the UK is worth obsessing about. I would rather be passionate about it, than apathetic; I would rather be trying to think about and provoke solutions than simply just waiting to see what might happen. However, with my hobbies such as guitar playing and climbing, I knew that the more time I spent on them, the better I would get; I would be rewarded with an increased repertoire of songs and more strength and stamina in my arms. The only reward I get for ongoing worrying about the NHS is frustration, anger, despair, briefly punctuated by glimmers of hope.
Obsessing about the NHS is getting me down. It’s making me miserable and I’m getting fed up of being fed up. But either I care enough to try to make a difference for the future or I stop caring all together, simply to protect myself and my family. I’m not sure I can do the latter, because there will be a part of me that would worry that giving up on the standards of healthcare in the NHS would mean that those standards would fall. Falling standards, simply put, would mean people are less well cared for, are sicker, and ultimately die sooner. How then can I stop obsessing, when I want the best for my patients?
Samir Dawlatly is a GP partner at Jiggins Lane Surgery in Birmingham. He combines clinical practice with being a part time house husband and an interest in social media, as well as publishing poems, essays, and blogs. He can be found on Twitter as @sdawlatly.
I have read and understood BMJ policy on declaration of interests and declare the following interests: I am a member of the RCGP online working group on overdiagnosis.