Abstract
The general idea of this book – thinking and writing about the changing roles of doctors – appeals to me. This is currently one of the most debated topics within medicine. Within their daily routines, doctors are increasingly occupying positions not usually associated with their traditional roles as doctors. Moreover, we are witnessing big changes as regards our patients’ knowledge of diseases. The optimization of financial and/or human resources for health care is also undergoing change. This results in significant interference for doctors in their clinical practice. Patients are increasingly studying their own diseases on Google or Wikipedia, gaining access to information of varying quality and wanting to discuss with their doctor the best direction to follow in their own cases. With regard to resources, public health plans and systems are shown as intermediaries between doctors and the diagnosis/therapeutics. Not everything that the doctor wishes can be carried out without the authorization of third parties, which diminishes medical power. The doctor himself has become the administrative professional who coordinates these third parties, managing the finite resources for a growing quantity of tests and therapies.
Within this context, Cavenagh, Leinster and Miles provide us with a series of texts aimed at the British public. These texts discuss the various career paths being followed by doctors. Some topics caught my attention. The idea of discussing the medical profession as being in a state of flux, as Leinster suggests, is interesting – traditional roles are changing and new roles are emerging. This discussion is in the first chapter of the book and highlights a certain conflict that current doctors experience between the image of the classic practitioners such as Hippocrates, and the physician’s role in a multidisciplinary team nowadays. I strongly agree with Leinster when he says, ‘The nature of future roles and self-identity of the profession and how it will interact with other health professionals is still unclear. We live in interesting times’.
In the fifth chapter, Cavenagh makes use of all her specialist knowledge to discuss the new role of the physician as an administrator. She shows us how the view of a doctor as merely a health institution clinical director has become obsolete. This chapter convinced me of the importance of major health organizations employing doctors in senior positions, and the decisive role doctors may play in the judicious allocation of resources within the health area. Of course, this generates two needs: a greater number of professionals to fill these new positions and medical education that also covers health service management. Unfortunately, the latter leaves a lot to be desired. Many doctors find themselves in pseudo-management roles, without the necessary management expertise to occupy such positions. This may well be why doctors have consistently refused to fill these roles within health care organizations.
In addition to these topics, there are many others that deserve the attention of the reader, such as ‘the changing working environment’, ‘accountability and performance targets’ and the ‘changing demographics of the medical profession’.
This book is worthwhile reading for doctors, as well as for professionals working in health organizations who come into contact with doctors, both of whom would acquire a greater understanding of the important changes that are affecting the role(s) of the health care professional. The majority of chapters discuss the doctor’s role within the British National Health System (NHS).