Intended for healthcare professionals


Why are doctors so unhappy?

BMJ 2001; 322 doi: (Published 05 May 2001) Cite this as: BMJ 2001;322:1073
  1. Richard Smith, editor
  1. BMJ

    There are probably many causes, some of them deep

    See editorial p 1078 News pp 1082, 1083

    Doctors are unhappy. They are not all unhappy all the time, but when doctors gather, their conversation turns to misery and talk of early retirement. The unhappiness has been illustrated in a plethora of surveys and manifests itself in talk of a mass resignation by general practitioners from the NHS.1 The British government is rattled by the unhappiness of doctors, recognising that a health service staffed by demoralised doctors cannot flourish. It has responded by trying to hand more control of the service to frontline staff. 2 3 But is this the right treatment? Treatment must, of course, follow diagnosis, and the causes of doctors' unhappiness may be many and deep.

    Doctors and patients: redrafting a bogus contract

    The bogus contract: the patient's view
    • Modern medicine can do remarkable things: it can solve many of my problems

    • You, the doctor, can see inside me and know what's wrong

    • You know everything it's necessary to know

    • You can solve my problems, even my social problems

    • So we give you high status and a good salary

    The bogus contract: the doctor's view
    • Modern medicine has limited powers

    • Worse, it's dangerous

    • We can't begin to solve all problems, especially social ones

    • I don't know everything, but I do know how …

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