Friday, 11 November 2016

The Endemic Epidemic

One of the things that you will see most commonly when GPs go into the written form, and usually after a list of moans, groans and gripes, is the tired claim that being a GP is the "best job in the world".

This sort of affirmation is a sign of somebody hanging onto the last fragment of a delusion.
They say on paper what they wouldn't say out loud.
And they say it so that they can still try to believe it's true.

They will probably imply in their recitation that it is a "well-known fact".
For example, by saying that it STILL the best job in the world.
They will use it to introduce us to their missive or to sign off on it in what, to me, is a "faux upbeat".

And, even in these well accepted days of evidence-based medicine,  they will fail to back up their comment with any data whatsoever. 
And we know the most extreme comments require the highest level of evidence.
It is shtick-ing plaster for the masses.

You might expect these comments to drivel out of anybody in the position of President or GP spokesman because they are paid to be in that position. 
What else would they say? 
Roll out a cheap, empty pick-me-up to engage the troops. 
It is a comment delivered by people who have never done any massively dissimilar job in their working lives. (This is more likely in medicine than possibly than any other subject due to its singular requirements). In other words, it is a comment made by the people least qualified to make it.
Apply a tourniquet over the wound and send the soldiers back out over the top. 

I can tell you that being a GP is NOT the best job in the world. 
It's a privilege. It is a challenge. It's worthwhile. 
But the best? Good heavens. 
Not by a long chalk.

But worse than that, it is a massive failure of imagination to suggest otherwise.
And those doctors experiencing such a breakdown of imagination, and ultimately such a failure of hope, are going to be of limited use. The complex dynamics of the possible power in, and of, the consultation rests in the deployment of that imagination. 

Stagnant doctors. 
Stagnant technique. 
Not bad people but nevertheless…if you don't have the power to flex the consultation, the best you're going to be is average.
And the best job in the world deserves something better than "average", don't you think? 
Maybe it even deserves the best. 
Why not?

A GP publicly externalising their internal affirmations is a long way on the road to a lie. 
Saying it. And living it.
It is likely that the compromise will harm them mentally and, because the mind and body are linked,  (they are, see any previous blog!) ….physically.
Square pegs. Round holes

A London service recently set up for stressed doctors has just warned that "soaring levels of ill health and addiction among doctors could 'destroy the NHS' ".
It has seen 3000 doctors - 10% of all London doctors. 
Not 1%. 
Not 0.1%. 
But 10% !!

7.7 % is "epidemic"
10% is endemic.

10% who have actually gone out "help-seeking", despite being doctors. Despite the stigma.
The health service has now been identified as an 'occupational health hazard' for doctors.
Their problems? "Burnout, depression, anxiety, and a syndrome indistinguishable from post traumatic stress disorder. The remaining third are doctors with addiction"'
I imagine only about 10% of professional sufferers would actually go to a service like that. 
But if that were the case, that would mean 100% of doctors were suffering.

Saying it's the best job in the world is a statement that is delusional. But it is also deliberately misguided. 
And, worse… it's unhelpful.
It implies wrongly that you are already at your peak potential and you should jolly well just get back to the front line, perhaps after a little counselling.

Here is the thing.
You don't need to do that if you don't want to.
Remember when you were totipotential human beings.
That's not an invite to reminisce. 
It's an instruction.
You can still do anything you want. 
Buckle up.

Honesty. 
Begins at home.

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