I am a doctor. As such I obviously speak with other doctors. In my various ramblings with colleagues (which we shall call multi-disciplinary discussions) I have noticed that over the past few years the ‘mood music’ has been increasingly sombre, with morale seemingly lower than ever. Of course doctors have always had views on their work and their working conditions, and I have in my collection of medical writings a prized tome from 1957 simply entitled, ‘Angry Young Doctor’ by one Louis Goldman. It seems that the problems with the NHS we are constantly hearing about have been present for a long time, and certainly, at least from a doctor’s point of view, things are, well, sub-optimal and always seem to have been.
To mis-quote Gilbert and Sullivan, a doctor’s lot is not (always) a happy one (happy one). The job is increasingly stressful, there is simply too much demand on resources, (which include time, money, goodwill) and not surprisingly things can and do go wrong. There is an attitude among those in charge of health services that mistakes are unacceptable, should never happen and when they do blame must be apportioned. Of course this is not published or disseminated in official documents, and all hospitals and healthcare organisations will have policies, guidelines and equivalent – reams and reams of them – which are often more fiction that fact, certainly in terms of how they are followed. This leaves the hapless shop-floor doctor in a very difficult position, as when things do go wrong and they do fairly often, doctors find themselves isolated, unsupported and at the mercy of a ‘system’ which considers their welfare a triviality and not worthy of proper consideration.
This is why, in my opinion, to work as a doctor requires much, much more than mere clinical ability, a good bedside manner, extensive knowledge and experience and the ever-difficult to define clinical nous. No, today’s doctor also needs training in law, management, social policy, conflict resolution and more. Obviously most of these are never taught in medical school of post-graduate training, and it is rare that doctors know what to do when things do go wrong.
So what to do? When in doubt, remember: “documentation, documentation, documentation”. Make sure you record things in as much detail as possible, including dates, times, places, people etc, etc. It is likely your accuser/adversary/opponent will not have done this and lawyers do like documentation. Do not ever try to go it alone when things go wrong, try to take a witness, ideally impartial, do not admit anything and seek advice as early as possible. Know about conflict resolution, try to be pro-active, take a deep breath and do your best. And if all fails, remember that there are alternatives to working in a dysfunctional environment – portfolio career anyone?
Consultant psychiatrist with extensive medicolegal, managerial and judicial expertise acting as medical consultant to ASM and an accomplished linguist and academic.