Doctors Working Alone
This post was suggested by some of the comments to my post about Changing Doctors. But in my experience of doctors in the last couple of years, increasingly specialists are working alone and doing much more of the donkey work themselves.
I’ll give three examples.
- In Hong Kong, I had a consultant speech therapist, wh0 did the X-rays himself to check that I could swallow properly. He even gave me a VHS video of it.
- My cardiologist in Cambridge, did the eectrocardigram on me, himself. Whereas the in most hospitals this is delegated.
- When I had the ENT examination after my episode with A&E, the consultant did everything himself.
I have a feeling that this approach is getting more common, as it obviously is more efficient and the doctor an modify his examination depending on what he finds. There is also no communication problem.
I’ve also been told that INR tests are done by the doctor, at my new surgery, so it’s not just at the consultant level. I’ve also had two specialist x-rays recently, where the radiologist worked alone.
To me it’s seems the way medicine is going for relatively simple procedures and some specialist complicated ones too. Obviously modern medical equipment helps, as in many cases it de-skills the actual examination and lets the doctor do what he does best, the analysis of the problem.
But what are the knock on effects in the number of anciliary staff that aren’t needed? headlines such as nurses made redundant are never good publicity, even if the downside is that there were so many more patients treated.
The Anonymous Widower 
This is interesting. I have had a variety of tests and scans over the past few years. Some there is a doctor present, some not. In my GP surgery many of the routine things such as BP, phlebotomy etc are done by nurses or health care assistants. Hospital visits have generally been private rather than NHS, and since they are because of injury I have had tests not necessarily related to the specialism of the consultant, for example if I walk any distance (yards not miles) my hands start to become more numb than usual, and the neuro sent me for an ECG to rule out any cardiac issues. All the scans I have had have been read and reported on by a radiologist. A couple of scans had a radiologist present as well as a radiographer. She wasnt a nice lady at all, I was very distressed, in great pain, I saw her rinse a piece of equipment under the tap and then put it back on the machine, but I was too upset to really register until 3 weeks later when the resulting abscess was the size of a small orange. They wouldnt let Neil even come in when they werent actually doing x-rays, and there were long gaps between them. Even when I was crying and clearly distressed.
Comment by liz | November 18, 2010 |