Dr Spence's article identifies that the NHS is plagued by complexity and difficult communication. So far so reasonable (if unoriginal). He then offers a solution...
Whilst I am ignorant of the 'bling' factor he alludes to, I can comment based on experience of many frontline senior staff (assuming he includes consultants in this term). One medical secretary supports a number of consultants (six in my case) and is part of a handful of staff that deal with administering approximately 60,000 patient visits a year. My experience and research is that this is fairly typical.
The idea that secretaries are there to type letters suggests a lack of awareness of what actually goes on in secondary care in this century. The article is also demeaning in tone to our secretarial colleagues as others have pointed out. The concept of consultants having 'their secretary' went out years ago for the vast majority of hospital doctors.
What about the suggestion that their role is to act as a barrier between clinical staff and patients? Like my colleagues in primary care, many queries do not need my input. Time spent in dealing with such queries is time not doing something else for patients. The average age of patients in an eye clinic is 77, does he really think that setting aside time for answering all text messages and email is wise? The vast majority of communications to our service is by letter, or telephone call. We already spend hours dealing with emails, letters and calls as it is. The reverse analogy would be to get rid of GP's receptionists as appointments can be made online.
I strongly suspect he is in a minority if he can type as fast as he can dictate. I would suggest it is a lot easier to learn to dictate better than to improve typing (and error correction / printing etc) to the same degree. It is obvious why it is more efficient to get someone trained at typing to type, and someone trained (and paid) to be a doctor, to be a doctor.
Has Dr Spence spent time seeing how things are in secondary care recently? It might help if he did- he may than be able to discard the uninformed polemic that weakens the article.
When faced with a large and complex structure, by all means look at ways to improve it, however: think first: why get rid of the glue that holds it together?
Competing interests:
I share a secretary with 6 colleagues
Rapid Response:
Re: Doctors no longer need medical secretaries
Dr Spence's article identifies that the NHS is plagued by complexity and difficult communication. So far so reasonable (if unoriginal). He then offers a solution...
Whilst I am ignorant of the 'bling' factor he alludes to, I can comment based on experience of many frontline senior staff (assuming he includes consultants in this term). One medical secretary supports a number of consultants (six in my case) and is part of a handful of staff that deal with administering approximately 60,000 patient visits a year. My experience and research is that this is fairly typical.
The idea that secretaries are there to type letters suggests a lack of awareness of what actually goes on in secondary care in this century. The article is also demeaning in tone to our secretarial colleagues as others have pointed out. The concept of consultants having 'their secretary' went out years ago for the vast majority of hospital doctors.
What about the suggestion that their role is to act as a barrier between clinical staff and patients? Like my colleagues in primary care, many queries do not need my input. Time spent in dealing with such queries is time not doing something else for patients. The average age of patients in an eye clinic is 77, does he really think that setting aside time for answering all text messages and email is wise? The vast majority of communications to our service is by letter, or telephone call. We already spend hours dealing with emails, letters and calls as it is. The reverse analogy would be to get rid of GP's receptionists as appointments can be made online.
I strongly suspect he is in a minority if he can type as fast as he can dictate. I would suggest it is a lot easier to learn to dictate better than to improve typing (and error correction / printing etc) to the same degree. It is obvious why it is more efficient to get someone trained at typing to type, and someone trained (and paid) to be a doctor, to be a doctor.
Has Dr Spence spent time seeing how things are in secondary care recently? It might help if he did- he may than be able to discard the uninformed polemic that weakens the article.
When faced with a large and complex structure, by all means look at ways to improve it, however: think first: why get rid of the glue that holds it together?
Competing interests: I share a secretary with 6 colleagues