Saturday, September 17, 2005

Who wants to be a doc these days?
Anthony Daniels

The White male doctor is a creature of the past, verging on extinction, according to an article in British Medical Journal.

No doubt there will be many who rejoice at this. The White male, they will say, has had his way for too long, in everything from the literary canon to politics. And even those who have no such ideological antagonism to White males may see in it a heartening sign of a new openness in the British society. Indeed, the fact that nearly a quarter of British medical students are of Indian subcontinental descent is a powerful argument against the idea of institutional racism.

But every silver lining has its cloud, and the cloud is this: a steep decline in the attractiveness of medicine as a vocation, profession and career. The demographic change, so lauded by some, may well be a symptom of this.

It has long been the goal of the government to deprofessionalise medicine and to turn its practice into a mere job. An independent profession, with its high standards and old traditions, is dangerous to the government, especially when it is as respected as the medical profession (doctors repeatedly come out in surveys as the people the general public most trusts), in a way in which a mere group of shift workers will never be.

And junior hospital doctors are now shift workers, proletarians of the wards. There is no doubt that shift work is appropriate to a proportion of hospital medicine - intensive care and accident and emergency, for example - but it is totally unsuited to most of it; it both dehumanises patients and deprives the work of most of its satisfaction. It is also grossly inefficient.

This is far from the only way in which the attractiveness of medicine has been undermined. The independence of doctors has eroded almost completely in the past two decades, and you cannot expect highly educated people who have undergone a long and strenuous training to remain contented for very long with being harried and reprimanded by people who are of lower calibre than themselves.

Of course, the prestige of a profession, and the respect accorded to it, does not evaporate in a trice. Thus, women and the children of immigrants who become medical students will for a time think that they are storming the bastions of privilege and exclusivity; but they will soon enough discover that the bastions have merely crumbled away and they have been fooled into taking possession of a ruin.

I write this in the house of an old friend of mine, a distinguished physician who came to England from India. His daughter has just qualified in this country as a doctor, and not long ago was enthusiastically looking forward to her career. A couple of years of shift work, however, have changed all that: the medical profession is no longer good or satisfying enough for her, and she is seeking a career elsewhere, as are 25 per cent of the new medical graduates.

(The writer is a retired GP and prison doctor) The Independent