This site is intended for health professionals only

Never glad confident morning again

The Jobbing Doctor never used to have trouble recommending a career in medicine...

One of the things that I have done throughout my time is give advice to people who have considered medicine as an career. I have always enjoyed doing this, either on an individual basis, or as a mixed group.

When I started my career it was, as they say a ‘no brainer'. This was what I suggested to them. I would ask them what kind of career offered more than medicine. Maybe an opportunity to work in an area that was special to them - surgery, or psychiatry or paediatrics, possibly?

They could have a whole load of career options to go for. They could have a life with a very transferable qualifications, and a medical degree from a British medical school was a prized possession indeed. The opportunities were there to work in America, or Australia or anywhere around the world. The best doctors would come to the UK to work in our system, and they were great to work with - I remember one surgeon from Zimbabwe who was so gifted that he took MRCP and FRCS at the same time and passed them both - a unique example of a physician who could operate. He taught me how to play competitive bridge as well!

For some years I was trotted out at my local university to be part of a panel of speakers who would be advocates for their individual specialties. I loved that, because I could mercilessly tease my other specialty colleagues about the narrowness of their fields and the limitations of their work.

It was fun, because I believed I was truly blessed in my career choice.

That was then. This is now.

The other day I was speaking to my good friend who is the local pharmacist. He has been invited by the local sixth form college to talk to the students about a career in pharmacy. He has done this for a few years, and isn't actually anxious about the standing up in front of 200 students. He has a sideline in amateur dramatics, so having an audience is very much meat and drink to him.

He and I now have a difficulty, because we have both seen our separate careers change dramatically in the last few years. He is now subject to targets and performance management. He now has to do pointless 'reviews' of medication to ensure that he ticks all the various boxes for his managers, who run a national chain of pharmacies.

He has lost his autonomy, and his ability to build up a pharmacy to his own specifications, and is being expected to peddle 'medications' that he knows are specious, but sell because there is a demand for them, simply because they make a fat profit from the gullible.

'What can I tell the students, doc?' he asks. He can no longer say that pharmacy is a great profession where you can offer a good service to the public and make a respectable living. He looks at his workload and recognises that more and more is around income generation, and persuading people to purchase medicines that are ineffective placebos.

I sympathise with him. Things aren't what they used to be, and we will never have glad confident morning (to use Browning's phrase) ever again.

He will of course fulfill his obligation to the college, and will put on a bravura performance. But he has a nagging doubt about the fact that he might persuade someone to go into pharmacy when he knows that, having his time again, he might now have made a different decision.

Nothing like medicine, of course.

Or is it?

Jobbing Doctor