“A supremely worthwhile, if sometimes unbearably demanding job”: Ray Tallis on doctoring

I’d hazard a guess that no matter how much editors like to think that readers enjoy having their ideas and prejudices challenged, there’s nothing in practice that the average reader likes better than an opinion that chimes neatly with their own. Which, I’ve no doubt, is why I enjoyed reading Ray Tallis’s article in yesterday’s Times newspaper as much as I did. An erudite and amusing thinker, Ray Tallis writes about the impact of the European Working Time Directive (EWTD) on surgeons and on hospital doctors in general. In describing the unintended but, sadly, highly predictable consequences of the  EWTD on continuity of care, levels of provision, and training and mentoring opportunities, he argues that doctors are in danger of being  “reduced to cogs in a standardised service and discouraged from giving full expression to a commitment to patients for whom they feel personally responsible.”

Not everyone of course buys into the notion that the vast majority of doctors are motivated by a desire to care and to relive suffering. Indeed the last UK government, fired by a deep mistrust of all the professions, saw it as a core task to dismantle what it considered the oppressive and self-interested role of doctors in overseeing the provision of healthcare. Which is why, for instance, GPs are strongly ‘discouraged’ from writing to particular colleagues in hospitals but are instead ‘encouraged’ to write to departments. And, conversely, why consultants, who want to ensure that the letters addressed specifically to them are not subsumed into the general pile of referrals, are forced to demand what would surely, under any other circumstances, be a right protected by law: the right to receive mail addressed to you. And it’s also why layers and layers of extra managers were put in place during the last 13 years and why doctors like me spend a (modestly) estimated 15% of our time on tick box tasks to ‘prove’ to the powers that be that we do what we do and what we’ve always done. Which is a shame really because there’s rather a lot of other things we could be doing for patients in that time.

The current UK government claims to want to reverse this misguided but uncomfortably effective drive to undermine and de-professionalise doctors. But just in case there remains within government a hardened core who still don’t believe that doctors actually care and want to do the best they can for patients, may I suggest you take time to read Ray’s brief plea. His request is simple but fundamental to any future attempts to improve patient care. He asks that we-society- start trusting doctors again, allowing them to do this satisfying, worthwhile, if sometimes unbearably demanding job, unshackled by mistrust, bureaucracy and legal limitations on how much of themselves they’re willing to devote to the task. It might just restore your faith.


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