To ask if you’re a doctor do you enjoy it?

[Ferryaway]

Was it what you expected? Salary, hours etc. just with all the Doctors going on strike at the minute it absolutely baffles me that somebody trains for so long to be so unhappy with their work.

How was the pp’s comment goady?

A psychologist is not a medical doctor, i.e. a physician or surgeon. I’m not belittling psychologists. But they’re not doctors.

Love-hate relationship with medicine.

Love the actual job and patients but hate the NHS and system.

There is a lot of sacrifice and investment of time, resources and emotion. The actual doctoring could be worth all the sacrifice but the system (i.e. the NHS) makes it incredibly hard to do the job well. I’m not a consultant but have been practicing for 10 years - working conditions are appalling and it really comes down to “grinning and bearing” whatever anyone decides to throw at you to progress.

You are constantly being shuffled to new hospitals once or twice a year so few people invest in you, you spend your time learning new systems and processes, it’s hard to put down roots or build support systems. Because doctors need to get constant feedback from all sorts of teams at least once a year, you’re at a disadvantage because you NEED them to like you so you can’t be assertive or insist on things (like insisting you be given your rota 6 weeks in advance so you can actually plan your life).

Because “flattening the hierarchy” has become paramount, lots of people get to take a swipe at doctors and we can’t say anything back or risk being called arrogant and not a team player (and getting negative feedback). I’ve been expected to do everyone else’s job - be a porter, take bloods, order hearing aids, get patients food, copy and fax medical records - while being utterly swamped with my own duties. And having to take responsibility for the patient as the doctor. It is utterly exhausting and disheartening.

I’m an NHS GP, similar vintage to @Prestissimo. In general, no I don’t enjoy my job. There are aspects of it that I do like, in that I actually generally like talking to people, finding out about their lives, and doing the “detective work” of medicine itself. Like others I do feel I have a vocation for medicine and I feel that my work is meaningful and worthwhile and really makes a difference in people’s lives. I also deeply appreciate after being a junior doctor, that as a GP, I don’t have to work many antisocial hours and always have weekends, nights and bank holidays off unless I decide I want to work in out of hours etc. And can usually get most of my annual leave at a time that suits me. I can also easily choose to work part-time without sinking my career forever, which would not be the case in every niche of medicine.

But unfortunately all of that is very much overshadowed by the sheer relentlessness of it all, the impossible workloads and even more impossible time pressures of having to do the impossible workload in an impossible time. Never EVER leaving work on time (and not because, as when you were a junior doctor, someone is super unwell and in desperate need of your attention, having a heart attack in front of you but because you need to fill in a podiatry referral form for someone’s toenails to be clipped). The fact that your work is never “done”, and is constantly added to.

Throw in a pandemic situation (where it became very clear we are simply cannon fodder and not seen as important to this country’s government), abusive patients, a tsunami of emotional need being thrown at you every day, general GP-bashing from the public, Dr Google (and now Dr ChatGPT as well, even worse!), impossibly long waiting times for secondary care, and every single patient wanting to discuss roughly five million issues in a ten minute slot (which also has to include medicolegally adequate documentation and any referrals etc needed as a result), plus the fact that all of the more straightforward (and quicker) consultations are now filtered out by pharmacists, practice nurses, and other allied staff such as physicians associates, leaving you with only the most horrendously complex or difficult medical issues or indeed just people that are difficult to deal with. Plus losing continuity of care due to this, and with it any meaningful relationship or understanding of the patient as a human being or chance to observe issues over time and possibly piece together connected problems, making the whole thing feel more transactional and less satisfying and ultimately less good clinical care.

Along with no time or opportunity to pee or have something to eat or drink when you need to, let alone exchange any meaningful conversation with colleagues, continuous interruptions from reception and task-switching needed, no proper staff kitchen, horrible depressing staff common room, migraine-inducing fluorescent strip lighting, uncomfortable chairs, buckets all round the place for drips from the ceiling in winter and increasingly furnace-like conditions every summer which get completely ignored by management with no adaptations or adjustments made for the fact that it’s pretty much 40 degrees indoors and hard to think clearly and certainly as quickly as usual. Plus the soul destroying somehow simultaneously deathly boring while also super stressful and meaningless activity that is appraisal and revalidation.

On top of all of that, not being paid anywhere near enough not only for the “actual” as opposed to “theoretical” hours worked, medicolegal risks and the length of specialist training required to do the job properly. With serious real-terms pay erosion of about 1/3 since the global crash in 2008. While physicians associates walk straight into the job from uni without having to pay their dues doing crippling intense 100 hour weeks as junior doctors including night shifts etc. But get paid around 2/3 of my salary, even though they are nowhere near as qualified or experienced and can’t even prescribe. And at the end of the day they are not doctors, let alone fully trained GPs. The fact that I am expected to prescribe for them and supervise their full clinics as well as my own, while they are paid 2/3 of my salary and the costs of living are ever increasing whereas we have basically had a pay freeze since 2008…

The job has completely changed since I first went into medicine. And it all just wears you down and leads to total burnout. Especially if your personal life has been stressful as well and/or you struggle with health issues, particularly mental health issues. Maybe I’d feel differently if I’d had a nice smooth ride in life with a supportive partner etc. Unfortunately I’ve had some really “major adverse life events” happen to me over the years not limited to domestic abuse, divorce, a child custody court case, single parenthood, the sudden unexpected death of a sibling, a close relative dying from COVID. I also have bipolar 1 disorder. Which I did not know at the time I decided to do medicine, or started or indeed finished medical school. In partial answer to OP’s original question, I was prepared for the job to be hard work with long hours and high stress levels, I even anticipated that there might be a pandemic situation before too long as it was “due”, however I would never have chosen to be a doctor if I knew as a teenager that I was someone who had a mental health condition that is quite so vulnerable to stress and sleeplessness. And I definitely DID expect to be more fairly paid for it. I did not go into medicine to become rich at all, money in itself isn’t a huge motivator for me, but I did expect to be more financially comfortable than this especially as I get older; I certainly didn’t expect to be worrying about paying normal bills for the necessities of life.

I loved my job as a junior doctor when I started out in medicine, despite the exhausting 100 hour plus weeks we worked at the time. I don’t know how much of that is because some of the difficult major life events I went through and my poor mental health were yet to hit me, or how much some of it was to do with being fairly junior and feeling “safe” that I could pass things up the chain of seniority if I couldn’t handle a situation etc. It may well also be that back then there was a lot more camaraderie, with “firms” still being a thing (basically teams of doctors who worked together on a regular basis), and things like doctors messes, free car parking, free on-site accommodation, and regular coffee breaks etc. still existing. I’d also say that things generally felt less pressured on an average day back then and we could truly aim for clinical excellence as a team, rather than just firefighting and trying to avoid a major catastrophe while never really being able to address anything properly due to lack of time, staff or resources. And when there was a more intense day due to staff sickness or flu season hitting etc, it was much easier to gear up and see it as a challenge rather than simply another daily exhausting grind. I would also say that I felt reasonably well renumerated for my work then. It all changed around the time of the economic crash in 2008 and Labour losing power in 2010, and I honestly feel we have never recovered as a profession from that time.

I’m not a doctor, but a psychologist with a doctorate. Our jobs are very different (obviously) but the medical doctors here are outstanding . Thank you . My job is easy compared to yours.

I agree with you about the “flattening of the hierarchy” thing meaning you end up being expected to do everyone else’s jobs as well as your own, and if you dare say anything you’re stuck-up and think you’re too good to lower yourself to do the photocopying etc! This is much less of an issue in GP-land as people there tend to understand that the GPs are best being left to get on with actual GP work! But I remember some of this from being a junior doctor, sounds like it’s got a lot worse though.

I'm a mid-career consultant in a subspecialised area. I still love my patients and the actual clinical work, but feel completely beaten down by systems/management issues and am actively working an exit strategy. I would not do it again and would strongly discourage my children from entering medicine.

I don't think anyone who isn't a doctor can understand exactly how the weight of responsibility and expectations wears you down, and it's impossible to understand that before you start training. Better pay won't remove that, but frankly, it does help. Today's doctors are not the doctors of decades ago. By that, I mean a large proportion of us are not males with generational wealth behind us and a stay-at-home wife to manage our non-working life. It's an unreasonable expectation that we do this job that takes so much from us without generous financial compensation, simply because "it's a vocation".

Ultimately, whether you agree with strikes or not, the reality is that we are haemorrhaging junior colleagues to Australia, Canada, New Zealand etc. at an alarming rate, and the reasons for that need to be addressed urgently.

I thought that was unreasonable too.

My son enjoys it. But a taxi driver told him that he wouldn’t get out of bed for what he earns!

Reading about all your experiences I’m so worried for ds who is spending all summer working for the UCAT and volunteering and preparing for his interviews and personal statement as well as doing “summer work” set by his teachers all because he has his heart set on doing medicine. He only decided to try for it a few months ago. I just worry so much that even if he does get in his life is going to be very hard. Plus knowing that he most likely will leave the uk as soon as he graduates. I’m also worried about getting older and sicker . I regularly think about suicide if I ever got diagnosed with dementia or any life limiting disease as I don’t want to be a burden on my kids as a single mum

@marmaladeandpeanutbutter A taxi driver, is saying they earn more than a doctor, don’t believe that for 1 minute.
Pull the other one, it’s got bells on it!

Even whilst respecting the job you do, the difference you must make to the life of others, I’m sorry, but you’re not a Dr in the real sense.

I understand why people might not be able to say more but now I'm intrigued as to what these niche roles are? What counts as niche? Appreciate people might not be able to answer.

Yes. I’m an ICU Dr. It’s worth every second of training, every unpaid hour and all the money I poured into becoming expert.

It is incredibly rewarding, meaningful work.

Consultant Anaesthetist here - I love my job and genuinely think I have the best job imaginable. It is a real privilege to care for patients and families and I try every day to be the best I can be. But as others have said, it hasn’t been an easy path at all and at times I did have serious doubts during training about why on earth I was putting myself, and my loved ones, through it. Life is much better now I am a consultant but the many years of training, moving hospitals, having very little control over my life were incredibly challenging and honestly exhausting.

My mental health took a huge knock during the pandemic and luckily I managed to get the support I needed. But sadly now I see so many of our residents struggling due to rotas, constantly having to change hospitals, the pressure of exams and trying to get training posts. I really feel for them because I only too well remember what it is like.

Would I do it again? Almost certainly yes. But hard to be objective and things are hugely challenging at the moment. But everyday I work with wonderful people, care for patients and get to do something I love - that definitely helps with the challenges to a huge degree!!

I have a couple of questions for the GPs on this thread;

My surgery is open 5 days a week but the individual GPs at my surgery are available for appointments 3 days per week typically and do appointments up to 6pm. On the days they do appointments they are always running behind because the appointments are only 10 minutes long and more time is often needed plus they need time between patients to do various things. It’s clear to me that this is a long and incredibly intense day and it probably ends quite late into the evening. I’m wondering if it would make it easier to allow more time for each patient (like 20 minutes rather than 10) and to spread these appointments out across the week so they are not being crammed into 3 days and the individual day is shorter and less stressful? Either that or would it better for the NHS to admit that an appointment takes longer than 10 minutes and pay you for the extended work day you are doing anyway? This would mean allowing patients to book in realistic appointment times up to 7-8pm rather than book in an appointment time but actually see the doctor 45 minutes after that because they are running behind?

Also I found out how much my surgery gets paid per patient, it’s exceptionally low, I work this out to be less than 2% of my income tax and NI contributions? Is this true, if it is I’m not sure where my tax goes as I would expect it to go on important services that I use like my local doctors surgery?

Because “flattening the hierarchy” has become paramount, lots of people get to take a swipe at doctors and we can’t say anything back or risk being called arrogant and not a team player (and getting negative feedback). I’ve been expected to do everyone else’s job - be a porter, take bloods, order hearing aids, get patients food, copy and fax medical records - while being utterly swamped with my own duties. And having to take responsibility for the patient as the doctor. It is utterly exhausting and disheartening.
I don't think this is anything new actually. You could be describing my life as a junior doctor in the 80s. Anything that nobody else wanted to do fell to the most junior doctor. In fact in the days with no computers there was an awful lot more "secretarial" stuff to do. Some of it is just plain old fashioned misogyny rather than anything else though. Back in my early days it was always me who was expected to make the post ward round coffee for the Consultant, never any of my male colleagues. And in fact that never changed. Even in the last months of my career when I was one of the most senior clinicians in the Trust I arrived at a meeting that I was to Chair only to have one bloke ask me if I was here to take the minutes and another tell me that he'd like his coffee white with one sugar. I don't think that he was best pleased when I told him that his beverage choices were really none of my business but that he should perhaps ditch the sugar. But basically a lot of that crap followed me throughout my career and I blame the patriarchy more than any other kind of hierarchy.
I have to confess that I rolled my eyes a bit though at the idea of taking blood not being a doctor's job. I did that probably twenty times on my first day as a junior house officer and I was still doing it if not on my last day as a consultant, certainly in my last week. In fact I did it increasingly frequently in my last few years as a consultant because it seems that, particularly out of hours, there was a dearth of people in the hospital other than we anaesthetists who were capable of putting needles into veins. Doing repetitive, relatively easy tasks can indeed be boring and frustrating but it is not valueless. It brings you into direct contact with patients which is never a waste of time and it makes you very good at those tasks. Put a dozen easy cannulas in every day and you vastly increase your chances of being able to do the tricky ones. Listen to twenty normal hearts when you clerk your routine surgical admissions and that one undiagnosed aortic stenosis will leap out at you when you hear it. But we don't do that stuff anymore and I think it's showing. Not that I blame the young doctors for that, they are the victims of policy decisions made by my generation if anything. Some things are better, but in many respects the baby has been thrown out with the bath water. I wouldn't want to be starting out now, regardless of how much better the hours are and I'm really glad that none of my children has chosen to follow in my footsteps.

@Justchilling07 I’m sorry you don’t believe it, but it is 100% true. Perhaps you need to get an accurate update on young doctors’ salaries vs taxi drivers, before you go round accusing people of lying.

Dh has been a consultant for over 20 years now, a Dr for 30 years. Hes not loving it anymore. He says It started to get harder and more miserable from the Cameron austerity years, and has rapidly gone down hill. Not helped by a string of disastrous CEOs at our Trust it has to be said. Hes still brilliant at what he does and is highly regarded in his field, but he's been beaten down by the lack of investment, poor quality management, and general low morale. Hes just trying to survive until retirement.

So I work 2 days per week at the moment, increasing to two and a half in a few months’ time. I work part time because I have young children at home and because I also lecture at the local medical school on one of my days ‘off’. So no, I wouldn’t like to spread my hours out. I’m cautious about doing a ‘half day’ because that’s 8am-1pm officially, but often involves not leaving the surgery until about 3 by the time I’ve finished my admin. So we’ll see how goes.

My usual days involve arriving at the surgery just before 8, spending 15 minutes logging on and inevitably restarting everything because there’s been yet another IT update. Grab a cup of tea. File blood results, action hospital letters and answer any queries since I was last at work. I do surgery from 8.30-12.30 with a twenty minute coffee break in the middle. We run at 15 minute appointments routinely, because patients nearly always have more than one problem nowadays, the population is getting older and more complex healthwise, and hospitals see hardly anyone long-term. So patients who 20 years ago would have been seen by a consultant twice a year are now looked after exclusively by us in primary care. I often run late despite these longer appointments although obviously try not to.

12.30-2 is lunch break/meeting/travel to or from our branch surgery, admin tasks from the morning, more blood results and hospital letters (these used to be released to us twice a day, now just a continuous stream, which is very depressing and means you’re never fully on to of it). Afternoon surgery runs 2-5.30 with, again, a twenty minute coffee break if I’m not really late at that stage in which case I skip it. At 5.30 I often have three or four patients to ring so that can easily take an hour. Bit more admin and then I usually leave at about 7pm.

No one can afford to pay me for more sessions (half days) seeing fewer patients each time. The practice has already taken a pragmatic stance of longer appointments, but this means that obviously there are fewer of them because we are humans and can only work so long in one go. The BMA thinks we can safely have 25 patient contacts in a working day. I generally see 26 each day in my booked clinics with additional phone calls as I need to and can fit in (my vain attempt to maintain continuity of care for my patients) and obviously all the admin on top. So we can’t reasonably do less in a day unless there are a lot more of us. We also don’t have enough rooms in the building to employ more clinicians even if there were enough money (which, as you’ve alluded to, there isn’t). So it’s a tricky situation.

I work occasional Saturdays on top of my usual working week - no extra money (to me) for that, it’s just done pro rata between all of us because the government think patients need weekend appointments. This would be fine except that we generally see the same patients at weekends anyway. We often get requests for earlier or later appointments, but honestly there aren’t many of us and we have lives too. What should really be the focus, I think, is that employers should sort themselves out and not punish employees for having occasional time off for appointments. But I know that is complex as well.

The intensity of my working day now is huge compared to how it used to be. It’s busy from the minute I walk in to the minute I leave. Honestly, I need a day off in the week just to recover in time to go again. It’s not just because I’m older (obviously the experience I’ve gained offsets some of my general knackeredness 😅), but the nature and full-on-ness of the job has completely changed. It’s hard bloody work. I enjoy it (mostly) and I’m well-enough paid (although wouldn’t do it just for the money), but it’s hard. I’m hoping to work until I’m 60 and then retire because honestly I don’t know if I could safely do much beyond that.

Sorry, this is very long and I don’t know if it fully answers your question. How the practice is paid, and how much, is also complicated but I can tell you there isn’t much to spare. Those in Whitehall are reluctant to give more money to GPs because (allegedly) they think it ends up ‘in the car park’ because GP Partners would just give themselves a pay rise. I can only say that that says more about politicians than doctors in my experience - the vast majority of doctors that I know and have worked with want to run a decent service first and foremost. We’re in the job because we want to do a good job for our patients. This kind of (government) attitude feeds into why so many doctors are pissed off and burnt out.

It's shit

It's the system I hate

Thanks so much for your detailed response.

It’s a really good idea that your surgery has 15 minute appointments. So often I’m rushing from work to get to an appointment only to have to wait for 45 minutes or so because 10 minute appointments just don’t work and the doctor is always behind so this is so much better.

Yes I would be cautious about the half day because inevitably that will turn into a full day so you may as well work another full day. That half day could be difficult for you to manage and be disciplined about your half day so your not staying too late.

I personally don’t understand the weekend appointment idea from the government. For working people like myself it is much easier for me to see a doctor in an evening straight after work at like 7-8pm because weekends are always busy or we might be away. I think evenings are nicer for doctors who are probably working until then anyway rather than having to do a weekend.

I know you say employers should accommodate appointments in the day but we really need to be focussed on growing our economy and being more productive as a country right now so I think evening appointments would be really good for that (as long as they are restricted to working people only) so people don’t take time out of work. There are also people like my husband who manages a water treatment site 12-13 hours a day 5 days a week (and doctors like yourself of course) who simply cannot leave work to to go to appointments in the middle of the day so he just doesn’t go if there’s anything wrong. Telephone appointments have been really helpful for working people like him though definitely but he does not have 30 minutes at 8:30 in the morning to ring up to book in a telephone appointment which is sadly how our surgery works (if you don’t ring at exactly 8:30 you don’t get an appointment). So basically he just doesn’t see the doctor if issues come up and just lives with it.

I figured doctors usually study or lecture on their other days which makes sense and I see that it is maybe not practical to extend a doctors week on that basis, I just thought that making the days less intense by spreading them out might make things easier but obviously not.

I hope your half day works out for you :)

Comprehension not your strong point is it?
It is clear what OP is talking about from their original post - perhaps it would be sensible to read the post first?

I have never mentioned who is more deserving of the title “Dr” - I have am talking about the job/profession doctor in the context of OP’s post.

Really who cares who is more “worthy” of the title or who had it first - totally irrelevant to the question about strikes, training time and job satisfaction.
It really riles me, as comments like this make it seem we have an inferiority complex (when most of us don’t) shoe-horning it into every discussion, it’s very cringeworthy and doesn’t seem very bright.

That is not what I said. The hours are better - simple mathematical fact and that is brilliant. What I object to is someone saying they are doing an on call, circa yester year when they mean a 12 hr shift.
Average 48hrs per week is done by many professions.

Striking for a reduction in the crippling loan tax would be far more beneficial for all students not just medical students.

Are other things worse yes - team spirit,cohesive care, working part of a team yes. The physical environment makes the job much harder and the lack of control of beds, where patients are sent etc make it far more frustrating.

It is not a race to the bottom, but acknowledge that progress has been made and there is some way to go. Challenges are different in different times some worse some better - it is not a race to the bottom.

I would still want to do the job if I qualified today

Try not to worry too much, if his heart is set on it it will be hard to dissuade him, and the actual degree is super interesting and does not necessarily have to be used to become a doctor ultimately, though of course that’s what most people with a medical degree go on to do. There are absolutely other options for graduates with a medical degree if they decide at that point that a life as a doctor is not for them. He’ll be exposed to a lot of the day to day work as a medical student so he’ll have a good idea of what he’s getting into by the end of his degree. And a lot of the issues are very U.K. specific, so if you think he is likely to want to work in another country anyway it’s far less of an issue. Most other countries treat their doctors a lot better!

I’m a single parent too. I think everyone worries about getting older and sicker. I don’t want to be a burden on my child either, but I know if my parents got dementia I’d be very happy to care for them (TBH it would be nice to have an excuse to not go to work anymore 🤣🤣 would far rather care for a demented parent anyway honestly!). But even if that’s not the case there are other options such as carers and care homes etc. I definitely wouldn’t want them to choose suicide. Suicide is never the answer and leaves a burden on a child psychologically anyway. I hope it’s not something you think a lot about generally, if so then do speak to your GP!

As a fellow knackered (no, experienced 🤣) GP I totally agree with you about the intensity of the working day being so much worse than ever before, especially since the introduction of physicians associates and pharmacy first schemes etc, and the pandemic of course, though really it just exacerbated trends that were already there. The intensity of our working days is a really big issue and one that is hard to truly comprehend from the outside (even our receptionists don’t really get it).

I would say definitely try to avoid half days if you can, and if you must do them try and go for an afternoon, even though I understand that isn’t the ideal when you have young kids etc to consider. I have experimented over the years with various schedules and a half day in the morning just never ever works no matter how disciplined a person you are (and if you’re staying late to call patients for the sake of continuity of care as lovely and needed as that actually is, I would say you’ll definitely not manage it!). The GP day as you know is kind of “front loaded”. And it especially doesn’t work if the practice is technically shut that afternoon! You just end up getting paid for a half day while working pretty much a full day. So avoid!