What do you think of when you hear the word “doctor”? Most non-medical people I pose this question to will inevitably describe the first thing that springs to mind, usually some sort of stereotyped semiotic such as white coats, stethoscopes, syringes, pills and so on. This is not wrong, unusual or noteworthy, as media portrayals of doctors will almost always include one or more of these. As an aside, it is always interesting to consider how television and films seem to often portray doctors as brilliant, maverick, caring, hard-working to the point of parody and all this despite their dismal private lives, rage against the system and an ability to never eat, sleep or go to the toilet.
Actually, when I think of the word doctor, I think of both the noun as well as the verb, having been doctored myself – twice. Yes, I am actually a ‘doctor, doctor’, not quite a doctor’s doctor, doctored doctor or any other potential permutation. Incidentally,’ doctor, doctor’ is not a typo or a form of Tourette Syndrome, and I now fear that some explanation is needed. I am medically qualified as well as academically a doctor. I hold a medical degree which entitles me to call myself doctor, even though this degree, at least in the UK, is an undergraduate degree. I also have a doctorate, a PhD (Doctor of Philosophy), which is, ironically enough, not in philosophy but rather in biochemistry of the bowel (don’t ask – I was young and there is a story attached). So I have in a sense been doctored twice, and both times were painful, albeit in different ways. I have recovered, however, and I sense a future blog about this, so stay tuned!
But I digress. What I think I am getting at is that stereotypes of doctors abound, and I don’t think most people would argue that doctors are associated generally with only one facet of their work, namely patient – facing, clinical activity, usually in a hospital or GP surgery. But there is more to being a doctor than this: To be honest, I am thinking more and more that being a doctor means being a polymath, someone with learning and ability in a number of fields, not just clinical work. When you think about it, this makes some sort of sense, and by way of evidence just look at any medical school curriculum and the vast array of disparate facts that neophytes have to ingest and retain long enough to pass some rather nasty exams. Having been there and done this, to this day I wonder why I had to memorise biochemical pathways and other such brain-numbing stuff, but maybe this will be vital in some future aspect of my career. Or maybe not. I am still waiting to find out…
So, apart from seeing patients, doctors do much more besides, at least to some degree. Of course doctors as a species are rather diverse, and their work takes place through myriad specialties, places, practices and more. My career, for example, includes clinical work, teaching, research, medico-legal endeavours and that old chestnut known as ‘management’. It is this last that I want to comment on now.
When most doctors hear this term they may well form antibodies, run away, have a rant or a tantrum or worse. Once they have calmed down they may likely equate this motive term with politics, endless useless and boring meetings about meetings, dull bureaucrats who exist to make the life of a doctor all the more difficult, endless dry reading of policies, procedures, edicts, rules and regulations that really should be marketed as a cure for insomnia. Yet there is much more to management that this, at least in the real world. In basic terms, I interpret the concept of ‘management’ to be about processes, specifically the facilitation thereof. In that sense we all ‘do’ management whether we realise it or not. Every time we do our jobs, whatever they may be, there is an element of management, be it formal or otherwise.
It is sad that the study/process of facilitation is so contaminated with politics that the word has become anathema to doctors and beloved of politicians in whatever context. Yet without good management in the wider sense systems are likely doomed to suboptimal running with suboptimal outputs. Yet management can be difficult, not least in large systems, where there is more to go wrong and more ‘managers’ to interfere. I particularly disliked ‘micro-management’ in a previous clinical post where apparently well-meaning bureaucrats would hover endlessly and try to ensure that every second of my time at work was spent ‘productively’, that is, doing what comrade bureaucrat wanted. This invariably involved a lot of meetings, memos, emails, words of varying substance and much wasting of time. Again, I suspect that this would form the basis of another blog.
But there is definitely more to management than meets the eye. Let me give a slightly tangential example: Within my increasingly vast home library of books is a collection of management textbooks, and here I will refer specifically to one I used when I studied management in the dim and distant past. Don’t worry, a didactic lecture is not about to be inflicted, merely an illustration. Looking at the titles of various chapters in this tome is instructive, and here is a random selection from the product range on offer:
Organisations, managers and the environment
Strategy, policy and direction
Managing operations and projects
Leadership and Management
Teams and Groups
Management and Motivation
The Management of Conflict
Looking at these just on their own and ignoring that pesky word ‘management’ for a moment suggests that these are indeed relevant to doctors, and of especial note is perhaps the last one, the management of conflict. So next time a doctor says that they don’t ‘do’ management, just smile sweetly, back out slowly and seek a second opinion. For any doctor who doesn’t understand at least the basics of management has rather a lot of learning to do…
Consultant psychiatrist with extensive medicolegal, managerial and judicial expertise acting as medical consultant to ASM and an accomplished linguist and academic.