Day 464

If I worked as an anaesthetist for one day a week, would I be good enough to be called a ‘Consultant’? Would you trust me to anaesthetise you? After taking away annual leave/study leave/ professional leave and sick leave, I may have 40 working days per annum. That adds up to about 320 hours per year. Is that enough to be an expert?

According to Malcolm Gladwell the author of Outliers, it is a myth that genius is born. It is made. He claims that Mozart and The Beatles are not so much innate musical prodigies but grinders who thrived only after 10,000 hours of practice. By that definition, it would take 31.25 years for those who work 320 hours per year to get really good at what they do.

Some Honorary Consultants in Psychiatry in the NHS have a clinical commitment of only one day a week. The rest of the time they do research and other non-clinical work. Even if they have 10 years of clinical experience as a consultant they would still need 21 more years to excel in their field. That would be roughly the same time they would be ready to retire. Is that fair on patients? Should that even be allowed to happen?

Do those 8 hours of clinical work include documentation, dictations, clinical meetings, talking to relatives and trainee supervision? How does this work? It doesn’t.

In principle, decisions are taken in the best interest of the patient. In reality, decisions are taken based on funding, which pot the money comes from, strict compartmentalisation, which segment of a service looks after what, which day of the week it is and what type of contract the doctors are on.

I am sure everyone does their best within their limitations. But as long as health is treated as a ‘commodity’ and patients as ‘customers’, we cannot get it right. NHS is now so far from what it was set out to be. I have always been proud to be a part of it and stood up for it when people criticised it. I believed that they didn’t realise how lucky they were to have it. But after seeing the way Saagar was treated, I feel deeply betrayed by my own people.

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