I want to drop the humbug. And I want to say ‘Bah, Humbug’ to whatever unreal world Dr Chris Gunstone1 lives in.
He may think professions are a ‘conspiracy against the laity.’ To some extent they are. But the conspiracy is necessary to ensure that the public get a good service. Professions arise in specialist niches where specific knowledge and experience is necessary to work effectively. Most professionals are motivated by their internal drive to perform well in the service of others. Relatively few people can be bothered to put the necessary time and effort to become a competent professional, and our worth arises because of the time and energy we have spent acquiring our skills. Our worth is enhanced because we can be trusted to get on with things, without the need for too much external policing. Our regulators should bear this in mind, for excessive supervision and micromanagement will destroy the motivation of many professionals, and so ultimately reduce quality of service.
The medical profession has a very specific set of knowledge and experience. As a doctor I celebrate owning the ‘medical gaze’2 and that I know how to use it well. It is a valid and necessary perspective on the world. I do not claim it is all encompassing, but to be ignorant of the medical perspective on things is to be partially blind, and most politicians are partially blind on many topics, so they need good professional input to help them. Most politicians are sensible enough to gather such intelligence.
The profession must have a major say on issues of health and illness3 and must give evidence to the policy makers as to what is effective or not. There is no evidence that the Department of Health has any clear idea of what health is, nor any coherent strategy for achieving it. Indeed the Department is lost in an endless cycle of fire fighting exercises4,5 and desperately needs a route out from them.
As doctors we are a major and valid voice within society, and have a very important role both with, and beyond, the treatment of our individual patients. The patients we see day by day are often the physical signs of much that is wrong with our body politic, for example social inequalities and family breakdown.
This country needs a powerful and assertive medical profession to draw attention to the many problems within its society. Maybe our role as doctors should be more political than it currently is.
- © British Journal of General Practice, 2007.