Wednesday, 25 July 2012

I love my job, I like seeing patients but I have had enough . . .

If you are a GP or a hospital doctor who has been in the game for a number of years, or a medical student or a doctor in training you will have heard, or will hear at some point during your career, the above statement or something similar from one of your colleagues. Who makes such a statement?

It is usually a senior doctor approaching retirement. Note what they say and its implications:

1) I love my job.

Most doctors' do but only if it is just confined to providing medical care something they were trained for, have spent years refining as a professional and hopefully getting it right.

2) I like seeing patients.

Most doctors like to see patients and discover their as yet undiagnosed illnesses. It is challenging and rewarding even though we know we sometimes cannot always treat our true enemy disease.

3) I have had enough.

Have had enough of what?

Well lots of things each in isolation a mere irritant but when such crap as appraisal, revalidation, protocols, NICE, QOF, tick box medicine not good quality patient care, care pathways, CQC, pathetic targets, yet another rearranging of deck chairs on the NHS Titanic called "reform" etc.etc. get in the way of and make treating patients harder not easier then something has to give.

An analogy we heard of is that of the bamboo curtain. A single piece of bamboo is easy enough to snap and walk through. But if you have many thousands of such pieces of bamboo arranged around you row upon row of retarded centrally determined government policy, locally enforced by PCT morons over many years that are medically of no use to patients you will realize why GPs and hospital doctors cannot wait to retire.

Some retire early and use their reduced pension to support themselves and also work as locums where they get paid better to do less and avoid the administrative burden that hampers their provision of good care.

Such statements are not said the day before they leave. Often it is a few years before they do so and by that time they have lost the urge to resist the institutionized retardation that increasingly gets in the way of good quality patient care. So they quietly plod on shrugging their shoulders as the next layer of bureaucratic retardation comes along counting the days until they can get out.

Most will yearn for a return to the past and almost all are fearful of the future for they know that at some point they will become patients and they like not what they see being done to their patients but they are powerless to change it. They can only protest but no one listens for the power is no longer with the clinicians.

In a younger doctor people would call this burnout but what would you call this pre retirement? Is a form of Stockholm syndrome?

We have seen it many times at ND Central over the years and also when we worked in hospital. It is like looking at a brightly burning Olympic torch and watching the flame go out. The torch is still there but the light has gone out.

The doctors' job is no longer an inspiration it is a once proud inspiration which when they retire will be put out onto NHS eBay for the next highest bidder for the job who will go exactly the same way given time.

Praise be to the Party for ensuring that highly experienced medics both in hospital and general practice can't wait to get out. It is a sad reflection of how little NHS society values its doctor's, and other workers' experience in the work place not by making it better but by making it harder for them to do what they are good at.

And the Party wants to make people work longer? Bet you that retirement on ill health rates due to mental illness go up.


blackdog said...

Somewhat of a 'cri de coer' cloggy land Doc'. Nonetheless one with which I have great sympathy. It is also one I have heard many times from my Hospital friends in Midlandshire.
Surely now that the winged foot minions of the great Olympiad have brought fire to the peasants, you can see what a great country this is and will change your view.
I hope you will stay and continue to fight for 'real medicine' instead of 'faux medicine'. We can ill afford to lose the few of you left that can actually distinguish between wood and trees. I could be tempted to steal the Porsche if you don't.

Doctor Zorro said...

The few that are left can achieve nothing. It requires the mass of the entire medical profession to stand up and say no, and that's not going to happen. Shame.

Lisa said...

I totally appreciate all of the work that went into this post! Career Statements

Muscleguy said...

The problem of course is that medicine is not only populated by the deeply caring and always competent. Things like revalidation, QOF etc are there firstly to prevent the person who qualified 30 years ago never having updated their knowledge but also to catch those who for eg are personally convinced the treatment they have used for decades works, despite the RCA's proving otherwise continuing to use it.

Every doctor thinks they know best and trusts their clinical judgement (otherwise why would you practise?) the problem is this can become blindness and arrogance.

That is not to say that the systems instituted to deal with these issues are perfect and cannot be reformed etc. But by calling for their removal you will get up the noses of your patients, who like me see the point of them and that they are there in part to protect me.

Anonymous said...

Dear ND,

I have long thought that the most damning thing about the NHS, and other aspects of British medicine is the desire to get over the line into a world free of hassle. Other countries Docs do not seem to be in a hurry to retire, perhaps their systems are not so bad after all?

Dr Phil

Anonymous said...

Describes me really. Never thought I would look forward to retirement when I qualified. Loved staying up all night to look after patients, and even working all weekend.

The problem is that although I want to keep learning, to keep updated, and understand (though disagree) why revalidation is here, I am given no time to do it - at the same time, I am asked to see more and more patients in less and less time, and asked to help reduce costs. Patients come first, the other stuff is not timetabled, and then I am castigated for not doing it. Holidays are not a rest as the work is simply all piled up for your return. Still love the job but the energy and the enthusiasm is slowly sucked out of me. Eventually all you can think of is when you can leave

Anonymous said...

What really annoys is how unnessecary so much is. All day everyday people put obstacles in your way of seeing patients, in order to meet one or other daft instruction from a variety of remote institutions.

Retirement: the pay is not so good, but the duty hours are.

Die PCTs sind Scheisse said...

Yup- sums me up. Officially 4.5 years to go, but I will probably go in 3- can afford to. And the irony is that for every one of us that retires, they will need over 2 docs as replacements. SO.... in about 3-5 years there will be a workforce crisis and the Daily Mail will be leading the demands for doctors to be forced back to work. Unfortunately, because of the regulations, that won't happen, as we will not have revalidated, so will clearly be mass-murdering public dangers.
I hope I live long enough to see the chaos that ensues.