Please do not blame the doctors who think GP job is 9-5 occupation. This happened when senior doctors working in hospitals started using pre-printed assessment sheets and giving more importance to research papers, statistics, investigations, tests and less importance to practical skill , clinical examination technics and patients history I made it very clear in my letter criticising introduction of pre-printed assessment sheet in hospitals. I knew computer may be good, and may be more efficient, but is not advisable for young doctors in training. It is the duty of the senior experienced doctors to identify deficiencies in history taking by a junior doctor, and help him or her to rectify the deficiencies and thus help them to be good clinicians (Srivatsa KM, Qual Health Care 1996 5: 121-122 ) Between 1996-2000, the NHS rapidly increased the number of consultants based on their qualification ignoring practical experience or knowledge. I found it hard to work as a staff or registrar in the hospitals and ignore wrong doings because some of the consultants had never worked as a clinician but were in research, preventive and community care. How can we now bring in changes? Knowing, majority of doctors who claim to be good (standard set by GMC) by attending meetings, obtaining certificates, going through appraisal and revalidation without providing any proof to show they have the practical skill, experience to mange patients. I was shocked when I heard a statement The NHS cannot expect GPs to be of high standard as I expect them to be made by a senior GP. I also found it sickening when I over heard a statement made by an RCGP examiner, saying the examination are designed to differentiate a British from a non-British graduates. This biased, discrimination and giving importance to academic qualifications, ignoring assessment of practical skills and clinical examination technique has resulted in a generation of doctors who are unable to differentiate Well from Unwell. Article in ADC, Collin Powell expects to find a tool that will help inexperienced doctors (Arch Dis Child 2013;98:319-320) differentiate so that the number of admission can be reduced. In 1990, one of my of my great teachers once told me the Membership examinations is a diploma that is not designed to say you are a specialist but one that proves the doctors has the clinical knowledge and is safe to be trained as a consultant. It is true, NHS has a generation of doctors with certificates, degrees to prove they are specialist but lack clinical acumen and practical skill to manage patients.
Posted on: Sat, 09 Nov 2013 22:17:02 +0000
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