Recent news events have once again highlighted the chasm that is developing between health care professionals and their patients. At the very least there is a dissonance in communication; at most a wilful disregard of one group for the other. Sadly I feel that many of the problems can be laid at the door of an increasingly transient workforce with a lessening of continuity of care that goes with that.
What do I mean by transient? In secondary care, compliance with EU directives on working hours has led to doctors, especially those in training, working less than 48 hours per week. In primary care, part-time working and doctors' disinterest in a career in partnership has led to an increased use of salaried and locum doctors. In both sectors there are more doctors but fewer interactions. The combination of these and other similar examples has led to a population of would-be patients no longer able to develop even a short-term relationship with any potential carer.
The lack of continuity of care has also coincided with an increased reliance on clinical governance and protocols. These have resulted in patients being viewed as cohorts and groups, where management of specific health problems is done via an algorithm, rather than, as historically, by a doctor managing those issues in the individual. The medical profession understands the health benefits derived from this paradigm shift but we have failed to communicate these benefits to the population at large. Perhaps this is because, almost by definition, we cannot do so because we deal with humanity on a personal basis! We have become so process -driven, not through malice but rather through a melange of well-meaning motives that we have lost sight of the holistic approach to medicine that was once ingrained in every medical practitioner. As a result we end up with a grotesque situation where parents are denied access to their ill child- a situation that defies all the elements of caring that should be the foundation of every doctor's ethos.
I recently listened to a business programme on BBC Radio 4 about how, within a generation, technology will replace doctors. The conclusion of the programme stated that the medical students of tomorrow may well be picked from those with GCE A- levels in the humanities or arts rather than, as at present, the sciences. The reason stated for this was that machines/apps/ mobile phones may be able to manage disease much better than clinicians but there would always be a need for a qualified doctor to provide both perspective and more importantly, a gentle touch, in dealing with people who are ill, vulnerable and scared. Sadly we seem to now have the former but not the latter.
We are currently in an professional environment where research-driven process is not being balanced by common sense. Even with all its failings there should always be a place for the dissenting voice born through experience to keep in check the march of the technocrat born through academic research.
Medical advancement should incorporate and build upon the past; not extinguish it.
We doctors need to be allowed to get back in touch with our own innate humanity so that we can return to serving, not dictating to, our patients.