Overtime

My girlfriend is also a junior doctor.  She still works shifts at the hospital and whenever I can, I pick her up from work.  

We noticed that if her shift finishes at 5pm then I should aim to pick her up at 5.15pm otherwise I’d just be waiting around as she never finishes on time.

It’s now 5.20pm and I’m still waiting for her as a patient had an unexpected heart attack on one of the wards.

You could build a city with the amount of overtime doctors do in England.  

Uber For Healthcare!

Sure it will have its place in healthcare, but in my opinion it really won’t have very much of an impact in how things are already done.  If you really are ill then you can always ask for a home visit from your GP, go to the out of hours services, go to pharmacy first or go to A&E.

I think fundamentally there are two problems with all these “Uber For Healthcare” apps and why they will never really take off.

It’s A Bad Business Idea

It’s essentially a really bad idea.  Not because it won’t work, but because everyone has already thought of it and is doing it.

There are already dozens (if not hundreds) of these startups in the UK.  Some CCGs are even trialling their own versions of it in and around Yorkshire!

Uber for Healthcare will happen.  But there will likely be a dominant service for each area of England as the landscape of healthcare is very different to the taxi landscape.

It’s a very crowded market.  Sure some of these companies might be successful, they might even be quite profitable.  But none of these companies will likely have a big share of the pie.  A share of the pie that will likely be eroded over time as more and more of these startups appear.

Doctors Are Unlikely To Work For “Uber For Healthcare”

Doctors are definitely undervalued in the UK.  We are undervalued monetarily as market rates do not apply as much in a socialised health system.  Most doctors are ok with this.  Most doctors became doctors because they genuinely wanted to help others.  And in any case we do get paid a pretty good salary as junior doctors and we get a really good salary as a senior doctor.

However, we are currently being extremely undervalued by the NHS as human beings.  Not a day goes by where yet another newspaper article doesn’t appear about this.

The question is, would doctors prefer working for a piece of software rather than the NHS?  Uber is not particularly well known for treating its drivers well.  I’m sure there are plenty that would.  But, doctors are much more skilled than your average taxi driver.  If we were going to work in the private sector why would we choose to work for a piece of software that would try to take a large percentage of our salary, potentially treat us really poorly and treat us like a cog in a machine?  There are already established firms out there that would happily recruit experienced doctors, pay them up to £100,000 for a 37 hour week, pay professional fees, give us our allocated time for essential training to keep up with revalidation and treat us with some respect.  Why then would highly skilled professionals choose to depend on a mobile phone app for their livelihood?  (Also, I don’t particularly find the idea of being beckoned by a random person with a smart phone, while carrying controlled medications with me appealing!)

But the main reason that most doctors would not sign up for this kind of technology is indemnity fees.  GPs who do exclusive out of hours work and locum work, pay around £25,000 a year to avoid litigation.  As society becomes more litigious these fees have been getting higher and higher over the last few years and is one of the many reasons why out of hours services are closing across the UK.  These fees are already this high when we have the patients medical records, past medical history, drug allergies etc. right in front of us and also the support of all the other NHS allied healthcare professionals.  The risk of just seeing a random patient with none of this support will make indemnity sky-rocket as well as massively increase the chances of being taken to court.

What’s It All For?

One of the reasons so many people hate school and education is because of the lies that they were told when they were younger.

They were told that keeping their head down and not speaking up was a good thing.

They were told that they would be given a good job for the rest of their lives if they played by the rules.

They were told that embracing their uniqueness was a bad thing and were instead told to do the “right” subjects, play the “right” instruments and get into the “right” universities.

Now in the real world they realise that none of that stuff matters.  In the real world speaking up and being unique are precisely the characteristics you need, to be able to do the work that matters.

P.S.

I’m just about to sit one of the last important exams of my medical career.

Here’s the lie: “It’ll make you a good doctor.”

Here’s the truth:  The exam only exists because it has to.  Because society and our regulating body demands it.

Exams

Amiodarone – check LFTs, U&Es, TFTs, CXR before starting, then LFTs and TFTs every 6 months…

2nd month of life – DTaP/IPV/Hib, Men B, PCV, Rotavirus vaccination…

T2DM diagnosis- symptomatic and fasting glucose >7.0, random >11.1 or HbA1c 48 (6.5%)…

I don’t think any doctor has ever looked back at exams and thought that it actually made them a better doctor.  In fact it probably distracted them from doing the work that actually mattered.

Freedom

Free from other people, from the daily grind of a busy city, from the stresses of having to deal with strangers.  Some say that the truly independent man would live in a secluded cabin in the woods – free to come and go as he pleases.  

I would say that this is the worst way to achieve the freedom we all crave.

True freedom is being relied on by other people.  The more you are relied on by other people, the more indispensable you are, the more freedom you will have.