Wednesday, January 03, 2007

Five Live Yardbirds

Back again.
I have it my mind that there's plenty to tell, but that it keeps slipping my mind. In my version of reality, I regularly imagine my occasional readers struck by how informative my posts are, or gasping at my rapier-like wit. Please don't disabuse me of this fragile charade.

While I was on holiday, I was at a friend's house having Christmas drinks. This year seems to have marked a watershed of sorts amongst my friends, as we now 'do lunch' or have people over 'for drinks', and it's all very civilised. I'm guessing we're trying to convince ourselves, and anyone watching that we're grown up now. Personally, I'm not fooled. Anyway, towards the end of festivities the doorbell rung, and was answered by the host's brother-in-law. A young woman came in, waving hello to one and all. She made it about half way to the kitchen before she came back to do a double take. She was in the wrong house. Brilliant. Apparently it was only that the walls were the wrong colour that tipped her off. She was undaunted by not knowing any of the guests. Very social I guess.

See, I was right. It's all slipped my mind.

I've seen a few posts about junior doctors hours recently; this is enough for me to throw my tuppeny's worth into the ring.

This eternal problem is forever rearing it's ugly head. Old school doctors worked long hours as juniors, got very good experience and an unrivalled breadth of knowledge. The current generations work less hours, and resent hearing endless "in my day" stories, from grumpy bastards like me. In this country the European Working Time Directive has had the final say in the matter, although in many cases people still work over their hours; they just don't get paid.

Personally, I think we should work longer hours as juniors. Someone's got to work the hours, and trying to employ more doctors to share the load is bankrupting the NHS, according to her holiness Patsy Fuckwit. Less hours as a junior means more hours as a senior, and less experienced seniors. I'm sure the policy is short sighted. There is also, it seems to me, an effect on continuity of care. Pa Shroom marvels at how the surgical service has changed since he first started at Shroomville General. Then there were 3 consultants, 3 registrars and 3 house surgeons. Now, the hospital has been down-sized, so there are less beds, but somewhere between 30 and 40 on the surgical staff.

I have had to field questions from house surgeons such as "how do I give an injection?" (Although I hope this level of lack of knowledge is rare)

It seems to me that a person needs a certain number of hours experience to be a good consultant. So less hours per year equals more years training. Although the government's idea id to shorten training. The choice may be between someone who is well rested, but doesn't know what to do, and someone who is tired, but does know. Yes it's unpalatable, and the idea that people should train in a certain way because their predecessors did is unacceptable.

But long hours seems to have produced good doctors. I'm not sure shorter hours and less training will.

1 comment:

DocBellaise said...

LoL at the sociable young lady who walked into the wrong house.