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Opinion Acute Perspective

David Oliver: A bittersweet farewell to my ward

BMJ 2022; 378 doi: (Published 07 September 2022) Cite this as: BMJ 2022;378:o2150

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Re: David Oliver: A bittersweet farewell to my ward

Dear Editor,

Thanks to David for his personal view. Powerful.

The one thing that stood out was his comment about the “exponential” rise in complexity of patients. Advancing medical science achieved by very clever people focusing on one system has led to much greater longevity. However, for generalists, both GP and hospital, this results in patients whose multi system “complexity” is beyond executive management by even the most motivated and brilliant physician. When things go wrong, which they do because of the complexity, the same one system people make comments on why things went wrong and the “brilliant” failing general physician feels a lot less brilliant. The net result is very good doctors feel like bad doctors, which makes them even less able to deal with the unmanageable complexity.

Competing interests: No competing interests

09 September 2022
Graeme Mackenzie