What annoys you about doctors?
Answer by Bas Kirmani:
Goodness, where to begin.
The things that absolutely annoys me the most about doctors is – generally – their willingness to do what they need to climb up the greasy pole of the medical system.
For patients, here is the terrifying truth; climbing up the ladder has very little to do with what you need, want, or expect.
As a patient, you might expect that a doctor would be rewarded for taking really kind, considered care of you; explaining the disease; where you should be improving things with medication, behaviour, exercise and movement; guidance on how to get the most out of your abilities and disabilities, a kind word, a gentle touch.
In truth, the stuff that *you* want your doctor to do and the things you want them to be are not only unrewarded by the system, often they are covertly punished.
The stuff your doctor needs to do to be a successful doctor has not only very little to do with you, often you are getting in the way.
The doctor wants:
1/ To read and write research papers: because a working knowledge of often esoteric research is regarded as desirable in the medical system, despite the fact that it changes little of your day to day care.
2/ To conduct an audit of something: not because it will makes things better for you, but because “clinical governance” is a career tick box that you need to cross.
3/ To get you out and the next patient in: Because throughput.
4/ To go on courses: because education aside, “Continuing Professional Development” is another one of those critical tick-boxes.
5/ To be sticking really big needles into you: because the juniors need to rack up a number of CVP lines, or arterial lines, or intubations to get kudos points and experience.
6/ To be in the mess room: because that’s where the other interesting young doctors are.
Here’s the rub:
1/ Explaining what your medication does and why it’s important? Takes too long: please go to someone else.
2/ Providing a carefully drawn diagram that truly explains to you what the pathology is and what you need to do to make things better, not worse? Takes too long: could be seeing another patient who could be a quick fix.
2/ Explain to your family what the options are? Takes too long: probably won’t “alter management.”
3/ Hold your hand while you’re in pain? Takes too long: Is there a volunteer around?
4/ Hold your hand while you die: Takes too long: Can someone else do this?
The savagery of modern medicine is that it is about throughput, numbers, credentialling, objective measures, pharmaceuticals and all important monetary value.
As a society, we have created this. We value the measurable, the objective, the Unit above the gentle, more subtle undulations of human experience and the human spirit. It’s that simple.
On a more positive note, I made a decision last year to leave the system to freelance, and I’ve never been more pleased with my work: I’m only accountable to my patients and my conscience. It seems to work well: here’s a picture of me holding a gift I received this weekend from a lovely patient with gastroenteritis, who appreciated the extra 15 minutes to actually explain what I was thinking and doing, and how I was going to care for them. That time, that care, meant much, much more to them than the fluids and the anti-spasmodic.
That face? Pure happiness at being appreciated.