Reviews Personal views

How important are we really?

BMJ 2005; 331 doi: (Published 15 December 2005) Cite this as: BMJ 2005;331:1481
  1. Ian Palmer, professor in defence psychiatry (
  1. HM forces, Southsea

    During a lull in the proceedings in the local out of hours service, a debate arose between me and another 50-something doctor as we awaited our call to action. The debate, if we can stretch the concept of the term, was based on how important we really are as doctors—or not.

    I suspect that we both needed to be of a certain age and able to look back on a combined clinical experience of about 60 years. In essence, our debate had all the hallmarks of the raillery of grumpy old men. Nevertheless, it set me thinking. I recalled sitting in a doctor's mess one evening when a medical registrar stormed in after a particularly long outpatient session. She was incandescent with indignity. “That's it. I've had enough. I'm changing to anaesthetics,” she spluttered. “Why don't they [patients] do what I tell them to do!”

    If patients are not taking our advice, then what are they doing in between surgery visits?

    I remembered having the same thought in 1978 when I started my …

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