Thursday, April 24, 2008

Why are doctors stuck at remaining skilled labourers ?

I met a very interesting person who is the CEO of a healthcare consulting company. I was showing him around HELP, and was asking him why he felt doctors did not do more to educate patients. His answer was very enlightening, because it offered me a new perspective about the healthcare industry.

He felt that most doctors were happy to remain just skilled labourers. They were so focussed on providing high quality medical care to their patients, one-on-one, that they failed to think about the bigger picture, leave alone trying to improve it.

This is extremely true, and I think there are many reasons for this.

Firstly, it's the way most doctors are trained. The heart of medicine is the doctor-patient consultation, and most doctors are taught to do this extremely well. This is why most patients are quite happy with their personal doctor, even if they feel the healthcare system itself is sick.

Secondly, doctors are not taught to look at the big picture - and even if they are, they don't know what to do about it. While they are very good at talking to individual patients and treating them effectively, their skill-set stops here. Thus, even though they are taught about community medicine, they don't know how to deal with the community or society at large.

Finally, doctors are not very good at taking collective action. Doctors are happy to become members of medical associations and societies, but these are often quite impotent, because they are not formed with the intention of helping to fix societal problems.

This tunnel vision is hurting both doctors - and their patients. Most doctors feel that if they take good care of their patients in their personal practise, they are doing a good job. I don't think this is true. As Rudolf Virchow pointed out many years ago, " Medicine is a social science and politics is nothing but medicine writ large !" As advocates for our patients, we need to take a more active role in helping to improve the care everyone in society receives.

We need to step outside the comfortable environs of the four walls of our clinics and hospitals ! Doctors have the training and intelligence to become agents for improvement on a much bigger scale - why are we wasting this opportunity ?

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