Reasons to be cheerful (times three)

Abstract

Why are doctors so bloody miserable nowadays? Whingeing medics spout their complaints all over the media. A Martian trying to understand how the NHS worked by reading Hospital Doctor would assume it was a derivative of Stalin's Gulag Archipelago. And hospital corridor gossip is dominated by dissatisfaction. There are a limited range of perceived culprits—politicians, managers, the MMC—and an even more limited range of solutions—more power and/or money for doctors, and privatizing the NHS either faster or slower than the current government. All of which is very strange when we consider the power of modern medicine to diagnose and treat illness. We are privileged to live in the era that medicine finally delivered in bulk what its proponents had been falsely claiming for centuries: accurate diagnosis and effective treatments. It is the huge successes of modern medicine that are the principal cause of the many real problems that do afflict our working lives, and we should be aware that these problems are often the inevitable consequence of good things. First, we are now trying to ensure everyone who might benefit receives appropriate health care. Even 20 years ago, a lot of modern medical care was not available to the old, the disabled, those with other illnesses or even just those whose local hospital wasn't a teaching hospital. The increase in work has been enormous and it is hardly surprising that our resources are often thinly spread. And remember that the struggle for resources for expensive new investigations and treatments is not just an NHS problem; it exists in every modern health care system. I don't like working in an understaffed, cramped facility, but it always was and always will be a fight to win the case for more staff and better equipment. Second, the age of deference is over. The NHS is not a charity, and patients are not automatically grateful for whatever treatment we deign to offer. It takes time to help patients understand what is happening to them, and to explain their options and our preferences. It takes time to explain why they need to keep taking their tablets despite what it said about them in the paper or on the net. And it takes time to establish a healthy rapport—a vital aspect in the age of powerful but dangerous treatments. It's quite handy for your patients to have a chance to develop some trust in you before you put them through whatever ghastly ordeals are needed to fix them. We don't need to be perceived as superheroes, we need to be perceived as normal human beings with special training doing the best we can in sometimes impossible circumstances. Finally, and least importantly: the pay is very good indeed. Don't compare with fat cat executives or heart surgeons with a big private practice, compare with your patients or any of the other members of your team, or even with what you were making before the new contract came in. And remember we get that generous wage for improving health and prolonging life in ways never imagined by all of our predecessors over the last two thousand years. This is about as good as it gets, and it's not bad. Get some perspective, and stop moaning.