Intended for healthcare professionals

Views And Reviews Provocations

Doctors need to give up professional protectionism

BMJ 2018; 361 doi: (Published 24 April 2018) Cite this as: BMJ 2018;361:k1757
  1. Clifford Mann, consultant in emergency medicine
  1. Taunton and Somerset NHS Foundation Trust, Taunton, UK
  1. clifford.mann{at}
    Follow Clifford on Twitter @DrCJM

The need for the medical profession to protect its role was, until recently, deemed essential. The notion that others might take on some tasks traditionally thought of as being “doctors’ roles” was regarded as an existential risk to the medical profession.

Medical societies, colleges, unions, and regulators approached proposals of clinical practice by other health professionals with deep suspicion. Concerns were often couched hubristically in terms of patient safety. But the prime motive was a fear that the profession would be diminished in size and stature.

If there were a shortage of work for doctors to do, then such attitudes would be a rational response. But these protectionist attitudes persisted long after the workload per doctor had become excessive. They have continued even when doctors’ workloads have become impossible. New clinician roles have not arisen out of some grand plot to do doctors down but from the need to deal with the workload crisis.

A junior doctor is a pluripotential clinician, …

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