Views & Reviews From the Frontline

So long for now

BMJ 2014; 348 doi: (Published 26 March 2014) Cite this as: BMJ 2014;348:g2343
  1. Des Spence, general practitioner, Glasgow
  1. destwo{at}

Writing in the BMJ over the past eight years has been a privilege, because my views are no more worthy than any other doctor’s. But it’s time to throw in the towel because I fear becoming repetitive and writing for the sake of it, which would be bad medicine. This is my last narcissistic reflection.

I’m no writer, I’m not a member of a book group, I hate jazz, and I possess no beret or thesaurus. I’m no academic, no expert; just a two-bit, chav-GP doctor. I also happen to be a card carrying contrarian. And, being a nobody, from nowhere, with no career to jeopardise, I’ve had the freedom to dissent against the prevailing wisdom.

The themes that underscored this dissent were the growing storm of medicalisation, overtreatment, overdiagnosis, polypharmacy, corporate pharma greed, cynical disease-mongering, doctors’ blinkered reductionist therapeutic mindset, fake chronic diseases, captured regulations, biased academics, and the manipulation of research.

Modern medicine is doing great harm. Doctors are failing in our duty to protect wellbeing. These are all unstoppable forces; protesting, it seems, is just howling in the wind. For me, medicine is about what we don’t do, rather than what we do do. It’s not about knowledge but experience, caring, and accepting uncertainty.

Although I continued to work as a full time GP, being in the BMJ each week meant rubbing egos with the great, the good, and the worthy on the warm-white-wine medical circuit. I didn’t understand them, and they didn’t understand me. I also spoke at conferences and meetings—sometimes well, but sometimes exploding into a disastrous, disorganised fireball. But I did it anyway because I thought that I should. I met a lot of interesting people and some less so. Occasionally I felt the white fury of those I offended, because everything is personal these days. But my articles were always about the debate; I was not always right.

Life’s a journey, and next time I’ll take a different road. Perhaps write a book. Or open a gluten-free quinoa sourdough muffin and organic skinny latte coffee shop. I’ll come out of columnist’s retirement one day—older, fatter, and slower—to slug it out for a couple more rounds. Until then, thanks for the emails, letters, and messages. Lastly, I couldn’t have written without the editorial staff who have deciphered my typo-riddled, broken prose.


Cite this as: BMJ 2014;348:g2343


  • Competing interests: I have read and understood the BMJ Group policy on declaration of interests and have no relevant interests to declare.

  • Provenance and peer review: Commissioned; externally peer reviewed.

  • Follow Des Spence on Twitter @des_spence1

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