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Doctors struggle to define the essence of being a doctor

BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7403.1352-b (Published 19 June 2003) Cite this as: BMJ 2003;326:1352
  1. Zosia Kmietowicz
  1. London

    Senior doctors hit a blank last week when they were asked to define their profession and left a sense of dissatisfaction among colleagues at a meeting entitled “Do we still need doctors?”

    Professor Graeme Catto, president of the General Medical Council, said that because of the erosion of boundaries between different healthcare professionals, it was “important that we define more clearly than at present what we expect of doctors.”

    However, both Professor Catto and Professor Carol Black, president of the Royal College of Physicians, struggled to capture the essence of what a doctor is in their presentations.

    Professor Black suggested that it was their skills in diagnosis and decision making that set doctors apart from other health professionals. But delegates at the conference said that, with the expansion of nurse prescribing and the delegation of other formerly “doctor only” tasks, this definition no longer seemed appropriate.

    Professor Bonnie Sibbald, professor of health services research at the University of Manchester, said that research showed that practice nurses could deal satisfactorily with 80% of patients in general practice, and patients were happy to see a nurse instead of a doctor.

    But nurses were not cheaper than doctors because, although they came at half the price of doctors, they were only half as productive as they spent longer with each patient. And even though non-physician clinicians were as expensive as doctors the shortage of doctors was driving this new profession forward.

    Professor Sibbald suggested a new identity for GPs of the future-as “community based medical consultants specialising in the management of patients with complex co-morbidities.”

    Professor Joe Collier, editor of the Drug and Therapeutics Bulletin and chairman of the meeting, said: “Because of the encroachment of other health professionals in the provision of health care, doctors need to ask themselves serious questions about what they do and what their special qualities are.”

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