We Need To Be More Than "Just" A Doctor
Dr Hunt articulates the feelings of many doctors on discovering that
the effective practice of modern medicine requires a range of skills
beyond the provision of direct clinical care. Her slightly delayed
entry into medicine may explain why this issue is troubling her now,
rather than later in her career: certainly these are sentiments I hear
more commonly from consultant colleagues than juniors.
However, to imagine that good medical practice is confined to the
delivery of care one patient at a time is to overlook the role of doctors
in organising healthcare systems and delivery in the wider context. It is
disappointing that Dr Hunt’s appraiser chose to frame the process in terms
of her Trust’s participation in the Clinical Negligence Scheme, since most
junior doctors value well-conducted appraisals. Nevertheless, cheaper
insurance premiums for hospitals mean more money to spend on healthcare,
and also indicate that organisations that carry out effective appraisal
make less clinical errors: presumably these are both outcomes that Dr Hunt
would approve of. Furthermore, research and audit without the active
participation of doctors will soon become clinically irrelevant or
ineffective. We have a wider responsibility for patient care that is
served by informed participation in these and many other activities, such
as teaching and continuous quality improvement (which also seem to get
irritatingly in the way of a narrowly focussed approach to patient care).
However, all is not lost. Dr Hunt appears well placed to fall into
the “Modernising Medical Careers” vacuum that currently threatens to
swallow those junior doctors who are too old for a foundation programme
yet too young to have secured a specialist registrar post. If this does
indeed curtail all opportunities for career progression she may end up as
“just” a doctor after all.
1. Hunt T. I just wanted to be a doctor. BMJ 2006;333:359.
Competing interests: No competing interests