Benjamin Franklin, in a letter to Jean-Baptiste Leroy in 1789, re-printed in The Works of Benjamin Franklin, 1817, said, “‘In this world nothing can be said to be certain, except death and taxes.”

As doctors, we have absolutely no control over taxes and, ultimately, absolutely no control over death.

In fact, we have little control over anything except what we do as doctors. If we can learn anything from the latest election it’s that we can elect to be passengers, or we can stand up and do something about the system we live in. At the end of the day, we are in a democracy, and it is no use whining and whinging about the result just because it wasn’t the result we wanted. And particularly if you don’t vote, then you have no platform to moan.

How does that relate to my article today?

I have not worked in the NHS for a good few years now, and I keep hearing how the system is failing and that control is being taken away from doctors, who are being told when and where and how things should be done by managers whose primary interest is in number crunching. Somehow this doesn’t sit right with me, an issue I have previously raised:

A few years ago, I was at a meeting of the Royal College of Surgeons. The discussion centred around how the government were dictating the method and regulations around FRCS and MRCS exams. The discussion was led by every knighted member of council and was quite scathing about the government. I, in my naivety, stood up and said, “Forgive me for being obvious, but aren’t we called the “College” of surgeons? Surely, as experts in our fields we should be telling the government what we should do, not the other way around?” I was met with around 200 steely stares from surgeons who had received knighthoods from the government of the time for doing exactly what they were told to do by said government. Understandably, I sat down quickly.

So, what is the answer? Is it going on strike? NO! I am a firm believer that you never ever ever go on strike. No matter what the situation and no matter what the belief is about “patients don’t suffer when we are on strike” – they do suffer. Not only that, but do you believe it helps our cause to have placard waving doctors chanting outside hospitals? Scenes like this run the risk of lowering us to the ranks of radical unionised proletariat that will rapidly lose public sympathy, and plays straight into the hands of administrations who wish to gain control.

How do we change things? We carry on treating patients. We do what we are trained to do. We regain public support and we tell management that they are exactly that – management. We are trained to deal with patients, and if we need 6 minutes or 15 minutes or an hour then that is exactly what we will do. Stand up for what we are and what we are trained to do. Don’t compromise, and one day, when you are like me looking back at 40 years of practice, you can look yourself squarely in the eyes and say “I did my best. I’m only human, not a god, but I did my best.”

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