Intended for healthcare professionals

Views And Reviews Primary Colour

Helen Salisbury: Why be a doctor?

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l2153 (Published 14 May 2019) Cite this as: BMJ 2019;365:l2153
  1. Helen Salisbury, GP
  1. Oxford
  1. helen.salisbury{at}phc.ox.ac.uk
    Follow Helen on Twitter: @HelenRSalisbury

Doctors spend a lot of time complaining. There’s a socially acceptable, almost obligatory, level of moaning; but, if you dig a little deeper, only a minority regret joining the profession. Some onlookers find this incomprehensible: we work ridiculous hours, for less pay than our city colleagues. We spend our time in physically and emotionally unpleasant places, surrounded by body fluids and bad smells, grief, pain, and distress. How can that be considered a good job?

Medicine is rarely boring, although it helps to be naturally curious. In a GP consultation little time is wasted on small talk: by the end of 10 minutes you may have heard about past struggles with alcohol, current debt or relationship problems, and fears for the future. Technically, the patient only came for a sick note or a new prescription for antidepressants, but really he came to be heard. You’re invited to share the important moments of your patients’ lives—the births, the suffering, and the deaths.

Sometimes we even make clever diagnoses: taking a careful history, doing a skilled examination, and then adding together the symptoms and signs and feeling a bit like Sherlock Holmes (or Gregory House). This happens less often than one assumed that it would at medical school, but there’s a joy in flexing those intellectual muscles and exercising those skills.

We may rightly worry about just how effective some of our medicines are or fret over numbers needed to treat, but we’re entrusted with the right to prescribe a vast array of drugs that do work. When patients come to us with infections, pain, or nausea, we have the tools to help. Even in the simplest of cases—seeing the relief on the face of the patient with a urinary tract infection as she leaves clutching her prescription for antibiotics—we get a feeling of efficacy, of really making a difference.

Perhaps the most important difference we make is in our role as interpreter of the medical world, offering explanations and reassurance, making the unknown less scary, and being a partner in difficult decisions. Our patients trust us to look after them and to work on their behalf. In the UK we’re particularly fortunate in that, on the whole, we can do the right thing for our patients without worrying about what they can afford.

Being a doctor is self evidently useful: no one ever asks, “What’s the point in doing that?” While our contemporaries do something incomprehensible in the world of finance or struggle to make a living in the arts, many of us feel privileged to have a job that is valued, secure, interesting, and—for all our moaning—relatively well paid.

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