Doctors’ dilemma unsolved

This is a brilliant tract against the times. Tallis records how the traditional vocation in medicine is ceasing to be renewed. What he says has a wider application to all professions and, indeed, to work generally. How can Britain sit casually by as a profession which, under oath, brings a lifetime of learning and dedication to our care is replaced by the highly paid medical salesman? Tallis locates a number of destructive forces at work.

Changes in the practice of medicine reflect changes in the wider society. The idea of vocation is increasingly no longer strong enough to determine what role people wish to play in life. A number now training as doctors may never practise, or, if they do, it will be for only a short period. This is a finding which would have been unimaginable 30 years ago. Being a doctor, and where to practise, is less a vocation and more a lifestyle choice. Ask anyone interviewing for junior consultant positions in London teaching hospitals. A significant number of candidates do not mention their desire to contribute to a team effort which has international status as a reason why they wish to be appointed. They single out instead how convenient the hospital will be for the life they will lead once their contractual hours are completed. The 2002 doctors’ contract was rejected by older doctors on grounds of its entrenching of political interference. Younger doctors voted against as it enshrined from their perspective anti-social hours into their working practices.

Tallis concentrates much of his attention on the rise of consumerism and with it the inexorable rise of political interference and control in matters which he sees as best belonging to the profession. The field of litigation ever more frequently determines how doctors behave.