Monday, March 02, 2009

Tomorrow's Doctors... but where are Tomorrow's Patients?

Mr Catto presided over a Day of Consultation, Introspection and Self-congratulation from the General Medical Council discussing Tomorrow’s Doctors. He managed to orchestrate a full days navel gazing, with one lay speaker and without a single mention of Tomorrow’s Patient. Apart from a couple of token medical students it was a day out with the over-60’s branch of Saga’s Scottish physicians. Not a surgeon in sight! Rather like Tomorrow’s World running a programme on Stone Age Britain, Mr Catto told us what he and his cronies thought about Tomorrow’s Doctors, and let us comment on his ideas. All boxes were ticked.

It is difficult to know where to start – Plus la change, plus la meme chose

Tomorrow’s Doctors are employees of the State and governed and managed by the NHS. They will know no other life. Technicians and public servants trained to work in the NHS with no jobs and no mercy for dissenters in a world where your doctor places the needs of the State above those of private individuals. The doctor acts as henchman, reporting dissident colleagues and disobedient patients in equal measure.

Tomorrow’s Doctors will treat patients according to Good Medical Practice. Good Medical Practice is the GMC’s version of Standard English Medical Practice. It may be a key document, but it is key to the Soma intoxicated chemical future of Huxley’s Brave New World.

Politics, immediacy and expediency have take the place of service and standards.

Tomorrows Doctors will be polite to patients, they will appear to listen and act in the patients’ interest but they will not know who they are outside medicine. Because they will sign up to a code of conduct which prescribes appropriate behaviour for every occasion. They will be medical automatons, trained to obediently follow guidelines rather than educated in the principles of health and disease.

Their understanding of Alternative and Complementary medicine may not be earth shattering but they will deconstruct double blind clinical trials of Upsidownsi-Doobyazole in their sleep. Meanwhile tomorrow’s Patients choose between homeopathy, osteopathy, a chiropractor, Alexander therapist egoscue and Pilates for their back pain. Whether they go to Tomorrow’s Doctor is debatable. Are patients happy with the NHS? Will they pop across the Channel? Turn to the private sector or go to complementary therapists?

Where will Tomorrow’s Patient get their health care information? Twitter or the Library? Who will they see and how will they suffer? Will they learn about their kidneys at school or from the Internet? Will they go to India or China for a second opinion? Already some patients are better informed than their doctors, this looks unlikely to change..

Mr Catto will be remembered for peacefully transforming a profession from imperfect autonomous medical practitioners to docile State Employees working for a Monopoly Employer. He has abolished GMC elections, overseen reorganisation of the National Health Service, given the Nation’s medical records to the government and handed over 150 years of independence to the first person who offered him a knighthood. He could do this because, like Anurin Bevan before him, he stuffed the doctors’ mouths with gold. UK doctors and GPs are the best paid in Europe and with some US exceptions, in the world.

There was one light-hearted moment before Mr Catto fessed up to his big secret. He let out his concerns about the impact of the Internet and the blogocracy. (Well done Dr Rita Pal!) And his big secret? he wants a private income. We have no doubt that Professor Doggo, like Mr Blair, will receive his 30 pieces of silver from Directorships, Big Pharma and Big Food.

Copyright (c) Dr. Liz Miller


angus said...

Just a few points Liz

1. I really love your blog (honest)

2. Don't you have to be human to have a navel?

3. I have a spare pound to start off his retirement plan.(sooner the better)


Dr. Liz Miller said...

Thank you Angus,
To answer your points
1 - Thank you, I love yours
2 - Yes, maybe that is the problem
3 - Quite right, time for whip round, but wouldn't we better giving the money to Remedy UK??


angus said...

re: point three-yours is a much better idea.


Anonymous said...

Bravo Liz :)

Love this post. I am still contemplating further banter on the GMC.


Dr. Liz Miller said...

Thanks Rita,

Thinking about Tomorrow's Doctors without thinking about Tomorrow's Patients is like running a Baby Clinic without talking to the Mothers.... sorry not a good example :-)

Its like organising a day trip to Margate and forgetting to book the coach.

Henry North London said...

Just remember Catto will get a final salary pension paid for out of our subscriptions. Thats where 35% of our money goes

Dr. Liz Miller said...

More in common with Blair than we might originally have thought!