In defence of consultants

By BBC Doctor Colin Thomas

The flavour of the moment appears to be consultant bashing.

The story is that they are a law unto themselves, swanning around doing very little work while earning vast sums privately.

There is no doubt that regulatory bodies must take decisive action against any bad professional, especially a doctor.

However, some recent 'own goals' by the General Medical Council in dealing with incompetent doctors have only served to undermine public confidence in consultants.

Increased regulation in the long term could be damaging to patient care

Dr Colin Thomas

I can assure you from my experience the overwhelming majority of consultants are nothing other than dedicated, hard working individuals.

In local district general hospitals the consultants work very long hours.

My two paediatric bosses when I was a junior quite regularly stayed with us until 9pm when we had a sick baby on special care baby unit, and then often we would have to call them in at night as well.

For them work came first and their lives came second.

Unfortunately, a perceived deficiency in regulation within the profession has handed the government an opportunity to increase regulation which in the long term I fear could be damaging to patient care.

My reasoning is that in medicine, as in other walks of life, you need leaders, innovators with vision and commitment.

Medical evolution

Medicine has always been run on a sort of Darwinian system.

The weak, I'm afraid, are weeded out, by the rigors of demanding learning schedules, demanding sleep deprivation combined with endless examinations and ritual humiliations.

Only the fittest survive, and they by virtue of the fact that they become consultants, are likely to be formidable, competent and single minded with patient care being uppermost. I say three cheers! that's what we need - not mediocrity.

What drives this process is the clinical freedom that consultants enjoy.

This represents their major, if not sole area of job satisfaction.

If you threaten this, then the reason for being a consultant will evaporate.

Money grabbing is not the issue, because studies have shown time and time again how medicine as a profession has fallen hopelessly behind all the others in terms of financial remuneration.

I'll tell you now if doctors were only 'in it' for the money then they'd probably all resign en masse from the NHS tomorrow, especially with nights on call thrown in for nothing!

I know that people I was at university with who went into other professions soon outstripped by a factor of four times what I was earning as a junior doctor.

In any profession there will always be rotten apples, and I agree that they should be removed, but don't confuse competence, dedication and responsibility with playing God.

Remember, to some patients whose lives have been saved 'God-like' is exactly how consultants are seen.