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Not a hospital doctor

Over 30 years ago, Jobbing Doctor came to a decision over his future career. He made the right one.

I think it must be quite easy to be a hospital doctor. I used to be one myself, and really didn't find it that demanding.

I am finding that some of my hospital colleagues, who were contemporaries are retiring, and have become quite thoughtful in their reflection. Certainly their jobs have changed immeasurably in the period since qualification.

I am relieved that I changed to be a GP in the 1970s: I would hate to be a consultant now. I know this might seem counter-intuitive, especially as ‘specialists' are generally very highly regarded by the general population, and have the potential to earn a lot more money, but I am pleased that I am not one.

Take a colleague of mine who is a cardiologist in the local hospital. She specialises in ischaemic heart disease. So, on Monday she sees a lot of patients who have ischaemic heart disease, then on Tuesday she sees a lot of patients who have ischaemic heart disease, and on Wednesday.....well, you get the picture.

There is actually no clinical diagnostic challenge here, as all the patients are either pre-diagnosed by the GP or by events. When she started, she dealt with heart failure, and arrythmias, and congenital heart disease, and valvular heart disease. Now it is just ischaemic heart disease.

It reminds me of Colonel Calverley in ‘Patience' by Gilbert and Sullivan who, although he liked toffee, bemoaned a life of ‘toffee for breakfast, toffee for dinner, toffee for supper...'

No, I would not like to be a hospital consultant. Many of them are quite envious of us at the moment, because we actually are now the repository of the real varied medicine. I have been aware of this in the last few years when I have had patients who were non-specifically unwell, needed an opinion, but could not be pigeon-holed into a particular area. Should I select a respiratory consultant because the patient is a bit breathless, or a haematologist because he is slightly anaemic?

Faced with a vague case (and they do happen), the usual pattern is for the patient to be subjected to a battery of investigations, and when they prove inconclusive, to either be aimlessly followed up by increasingly junior and junior staff until someone discharges them, or be randomly cross referred to another "specialist" who investigates their little area, and so it goes on.

No, I would definitely not want to be a hospital consultant for other reasons as well.

Working at nights and weekends are a thing of the past for me, and I shall never have to traipse out to some block of flats to examine some screaming child at three o'clock in the morning. Never again. When I come back home, I change from Jobbing Doctor to ordinary bloke. I like that.

Finally, I do not work for a hospital trust. Long gone are the days when consultants could develop their own interests, and work on cases and research that interested them.

They now have to follow trust policy, and will have to work the hours and clinics dictated to them by the management. I suppose this is responding to the demands of the system, and we (as patients) ought to be happy that our local hospital is been managed by a team. I think it stifles innovation, and reduces job satisfaction.

No, you can keep your status and extra money; I am content that, 33 years ago, I arrived at a career crossroads, and took the correct road. Being a Jobbing Doctor suits me very nicely, thank you.

And not a hospital doctor.

The Jobbing Doctor is a general practitioner in a deprived urban area of England

Jobbing Doctor