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The Best Thing About Being a Doctor? It's Not What You Think...

There are so many excellent aspects of being a doctor you may think it difficult to pick the best one. Fear not. The good news is I have the answer. The bad news is, it's not what you think...

There are so many excellent aspects of being a doctor you may think it difficult to pick the best one. Fear not. The good news is I have the answer. The bad news is, it's not what you think.

First eliminate the sensible reasons for embarking upon a vocation in medicine, the benefits that parents point out: a job for life, employee benefits such as sick pay and maternity leave, and a public sector pension. Next disregard obvious reasons, stated by eager applicants during their interview for medical school. Helping people, making a difference, and job satisfaction. Leaving the irreverent: nudity, black humour and 'in' jokes are the domain of sniggering, usually male junior doctors. It can be amusing but is far from the best thing.

No, the best thing about being a doctor in the NHS today is having insider knowledge. Knowing the weak points in the system. Being able to identify where systems break down and having the know how, ability and confidence to intervene. Being able to remedy problems in a timely manner, averting disaster or just gently steering the plan back on course is something I am eternally grateful I can do. Not just for me but also for my friends and family.

I know how best to access a busy consultant (phone their secretary), I know my notes are unlikely to follow me to a specialist centre, but I understand the language and can bring the new clinicians up to date accurately. I know when to push the receptionist at the GP surgery for an appointment with the doctor instead of the default triage by nurse. I even know when antibiotics are really needed and when one is truly suffering a virus. (Further I understand why antibiotics don't work to treat viruses so I am content when they are not prescribed.)

This is all good and helpful but insider knowledge of the foibles of the NHS is not always an asset. I am personally embarrassed for the NHS when I hear tales of those who have fallen foul of the monstrous convoluted system.

A distant relative with back pain from a spreading cancer, being treated by the practice nurse for two weeks as a urine infection with 'even stronger' antibiotics, without, unbelievably, analysis of the urine. My neighbour's appointment that never materialised: she didn't want to bother anyone (or didn't know who to bother) to chase it up. Appointments get lost in the system delaying treatment and care. My friend's mother-in-law, discharged from hospital on a public holiday with inadequate pain relief medication, unsure how to proceed. No information about her hospital stay accessible to the out of hours GP or accident department meant her further care began in the dark as she did not know what operation she had had. (Nor did I!) And those who nod while the doctor talks yet cannot hear him, or do not understand his accent or do not know what he actually means. They are too reticent to ask, lest they appear stupid.

With every anecdote I can see clearly where the system has failed the patient and I almost want to apologise on behalf of a health service I feel I represent. So I advise how best to find the pieces to pick up, I confirm they are correct to be worried and reassure that they will not be wasting the doctors' time. I try to explain why the situation might have arisen and perhaps justify it a little by describing the processes behind the scenes.

All the while I am wondering how it ever works for the majority who have no medical friend or relative to run things by and who must fend for themselves when subject to the mercy of the system. The reassurance I feel, of reliably accessing and receiving health care for myself and those around me is definitely the best thing about being a doctor.

Dr Ellie May is a Consultant Anaesthetist and author of two books. Read more at