Viewpoint: Professional powerlessness: reflections from a WhatsApp group

My schoolfriend, a junior doctor, added me to a WhatsApp group chat entitled ‘Shenanigans’. Initially, I thought this would be a forum to plan wild nights out as we did before adult life took over and to share hilarious anecdotes. Soon, the irony of the group name dawned on me as I realised why we were hand-picked. All of us, close since the age of 11, are now working in health — as medical consultants, GPs, lawyers, policymakers, civil servants, managers, advisors, and academics — all united by our firmly held belief in a publicly owned NHS.

Formed at the time of the junior doctor strikes, our group has become a forum for venting political frustration. I have picked up on a whole gamut of emotions conveyed by my old pals — anger, disillusionment, incredulousness, fear — all driven by an ever-increasing sense of professional powerlessness.

Our exchanges consist of sharing video and newspaper article links, the occasional Hunt-related expletive, and with Chomsky’s invectives forming a large part of my contributions. All underpinned by our individual Brexistential crises (in my case, Polish passport deportation angst) and PTSD (Post-Trump Stress Disorder), and a shared dismay at finding ourselves trapped within a neoliberalist, post-truth dystopia. And yes, we are keenly aware of our armchair activism, interspersed with occasional, to use Berry’s framework,¹ high-resource, low-impact outsider group political strategies, namely (hashtag) strike selfies. As time goes on, my friends share petition links by the dozen.

As a social scientist, I reflect on our social media chats with a heavy heart. To me, they encapsulate a wider wave of professional disempowerment, a lack of tools to make a real difference, deeply seated in policymaking that has since the early 1980s sought to de-professionalise and undermine the autonomy of the medical doctor. There is an obvious risk that the stifling of the professional voice in politics makes for uninformed, incoherent parliamentary business. Further, my friends air cynicism around Hunt’s apparent ‘de-politicisation’ of the NHS as moving it even further away from professional input into decision making and straight into the capricious clutches of the markets.

Against this backdrop of political powerlessness, our WhatsApp group is an important part of our support network; it helps to reduce our isolation and gives us space to vent our disappointment with health reforms increasingly driven by an agenda at odds with our professional values.

Notably, Clare Gerada recently called on colleagues to address the multifactorial systemic issues within doctors’ broad working environments that may contribute to the decline in their own mental wellbeing.²

Our chats also convey our need, in Don Berwick’s terms, to be part of something greater than ourselves, guided by professional knowledge, but valuing citizenship over professional prerogative.³ Shenanigans indeed.

• © British Journal of General Practice 2018