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Brief encounters: Dr Mike Dixon

Dr Mike Dixon is chair of the NHS Alliance, adviser on commissioning to health minister Lord Darzi, and a GP in Cullompton Devon

Dr Mike Dixon is chair of the NHS Alliance, adviser on commissioning to health minister Lord Darzi, and a GP in Cullompton Devon



What made you want to be a doctor?

As a child I envied the knowledge and power that doctors had. In my gap year before Oxford I worked in the autoclave department of a missionary hospital in Zululand and the romance, heroism and sheer usefulness of those missionary doctors sealed my fate.

What would most improve medicine in the UK?

Strong, disinterested and empowered clinical leadership. PBC and strengthened PECs will help but clinical leadership is still on senior management's terms and we, as clinicians, are still too tribalistic. Our credibility and our knowledge of our patients and their needs puts us in a prime position to create a much better NHS without the hype and bureaucracy.

What would most improve your working life?

Removing the computer. I didn't become a doctor to become a computer operator.

Who has had the biggest influence on you?

My wife, Joanna, who is an artist. She is all right brain and has shown me how wrong you are if you think that being a good doctor is simply about good problem solving and mastering the sort of communication skills taught at medical school. Medicine and inspiring our patients to get better is far more subtle, intuitional and illogical.

Which historical figure in medicine do you most admire?

He may not be historical exactly, but it is Dr Anthony Barker. He ran the missionary hospital in Zululand that I referred to above. He was treating and operating on patients in terrible conditions with the menace of apartheid stalking his every move. He and his wife Maggie continued working in missionary hospitals to old age. When they did finally retire their tandem collided with a juggernaut and both were killed instantly.

What do you think will be the biggest change in gen. practice over the next 10 years?

That depends upon us. As commissioners and providers, I think and hope that we will vastly extend our role beyond the consultation to becoming responsible for the health, wellbeing and services available to our patient population. This extended role for GPs and general practice will make us local leaders and allow us to integrate with the wider NHS in a way that never really happened after 1948. In the transition, we will need to fiercely defend our prime role as family doctors.

Are any members of your family doctors?

My son Finn is a doctor and my eldest daughter, May, is studying to be one.

If you weren't a doctor what would you be?

As a slightly unsuccessful introvert I like to be the person behind the scenes that pulls the strings. I would like to have been a press officer or news editor. In a way that is what we do as doctors – provide a "spin", an interpretation on a whole range of symptoms and diseases that the patient presents us with. That "spin" is probably far more important than the medical diagnosis or treatment in determining the patient's future attitude and ability to cope with his or her problem. I also quite like the idea of being a civil servant and pulling the strings of the Ministers who think they are running the country

What advice would you give to someone considering a career as a doctor?

I would say that it is the best job on earth. No job is so satisfying, varied and important. No other job gives you such access to people's minds and lives or such understanding of yourself and the meaning of life.

What is the best thing about a portfolio career?

It is about the variety, the highs and the lows and never being bored. One day I will be doing an 8:00am to 8:00pm day in general practice. The next I may be meeting with senior managers or Ministers at the Department of Health, special advisors at No. 10 Downing Street or the Prime Minister's officer. Or I may be providing input as a Trustee of the Prince's Foundation at Clarence House. Apart from the variety and challenge, there is also the possibility of making a difference in different areas and, whenever one area is going badly, there is normally one that is rewarding!

And what is the worst?

It's probably the feeling of never "being entirely off". I get important calls nights, weekends and bank holidays (particularly from the press). I also spend a lot of time (particularly in the middle of the night) trying to decide on the priorities for the various organisations that I am associated with. And I am always writing articles and speeches in my head.

Why did you get involved in GP politics?

I didn't like being controlled by others, especially when they didn't know what they were doing. It all started with Norman Fowler's Green Paper many years ago, which was a first attempt to say what GPs should do. I think the issue that started it all was having to measure everyone's height annually! Fundholding, managerialism, bureaucracy and political expediency and ineptitude have all kept me motivated to continue in GP politics.

How interested are you in money?

Not at all, except on the one or two occasions, when I have had to be because spending was greater than income. The idea of watching money markets (if I had any savings), money programmes or spending time trying to get the best interest rate or savings seems to me like a waste of the extremely small and precious time that we have on this earth.

Is medicine a vocation?

Of course it is. If it is anything else, then doctors are simply commodities, market rules and the NHS is lost.
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What makes you happy?

Developing a professional friendship with patients and seeing them overcome the physical, mental, social and cultural barriers to having healthy and fulfilled lives


If you had £200 to treat yourself, how would you spend it?

I would pack a hamper of smoked salmon sandwiches and champagne and buy a day's trout fishing on one of the "wild" stretches of the Test".

What is your secret for balancing work and family life?

I don't think I have one. I try to maximise working time when I am away from home – I do ten hours worth of paperwork, writing and preparation for speaking engagements on the train each week and I reserve my "thinking time" for the middle of the night, when the family are asleep. When I'm at home I try to give (that awful word) "quality" time to the family. They are fortunately pretty vociferous in getting my attention.

Dr Mike Dixon: I became involved in GP politics because I didn't like being controlled by others Dr Michael Dixon

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