Surgeons: elitist know-it-alls or defenders of patient values?

In Evidence-Based Medicine, Health industry, Professional Organisations on January 28, 2009 by Alan Lovell Tagged: , , , , , ,

John Black, the head honcho of the Royal College of Surgeons, writes in an opinion piece on BBC News Health website that “the doctor-patient relationship has been damaged and […] that a single consultant should once again oversee a patient’s care.” He does make some very valid points, for example:

“…[the] cord between GPs and surgeons has been cut by the computerised “choose & book” system, which purports to offer greater patient choice but which has had the opposite effect. You may now select the hospital based on sets of centrally gathered statistical measurements, rather than the right doctor for you with professional advice and support from your GP. How many patients know enough about the health service to make a really informed choice? I believe that patients genuinely welcome advice and input from their family doctor on which specialist may be right for them as an individual – a proper complex person not a statistic.”

This sounds great, but assumes that experts are just that, expert, and that the GP is also switched on and raring to go. But I fear that there are a lot of very average family Drs out there, who have already themselves started to cut the chord between one GP one patient, replacing it instead with one practice one patient, so that they can squeeze more people in, hit more targets and earn more money. Patients would not be demanding choice if everything was as rosy as Mr Black suggests it is (or would be, if professionals were left to their own devices). Surgeons losing control of THEIR waiting lists is something of a bugbear for Mr Black…

But to be fair to the RCS, they have welcomed the findings of the WHOs ‘checklists can stop surgeons taking out your wrong kidney’ trial. I would have assumed that they’d consider such simple activities as somehow beneath them. To gain an insight into the life of a surgeon you can watch a couple of typical, everyday sorts at work on YouTube.


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