Doctors and commitment

Nice work—shame about the job

Doctors' working lives are changing radically. Out of hours cover by general practitioners, the new deal on hours of work for junior hospital doctors, and the changing roles and responsibilities of hospital specialists all raise important questions about commitment. How should we, as people with careers to follow and home lives to lead, balance patients' expectations and the demands of reorganised health care with the need for a satisfying and creative job? The patient, the service, the profession, or some higher ideal—to whom or what should doctors be committed, and to what extent?

The doctor-patient relationship is still central to our work. The recent document from the General Medical Council in Britain underlines that doctors must make the care of their patients their first concern.1 This encapsulates a principle of practice that has remained unchanged for over 2000 years and underpins the idea of what a doctor is. However, the context in which this relationship exists is changing so fast that a gap seems to have opened between the ideals of medicine and the realities of doctors' work experience. The “good …