Medicine - a lower status career?

[ridinghighinapril]

Just read the "states schools eclipse Eton in A-level rankings" thread in the secondary section. A couple of posters mentioned that medicine was viewed as second-rate career (paraphrasing, as I can't remember the exact terms used) by those in private schools.
I was a bit but curious whether there has been a shift in perception. Interested to hear views!

And a lawyer/client....but no such boundaries about a parent having a relationship with a teacher of their child.

After many instances of confusion as to my job, I always introduce myself as Dr. X. As a female doctor it was often thought I was a nurse/ radiographer/ other non medical person as I couldn't possibly be a doctor.
I don't refer to patients by their first names either.
The days of paternalism in medicine are long gone in the majority of cases.

I'm a GP. Like every othe NHS Dr I know, I hope very much that my kids don't do medicine. The actual job is fantastic and endlessly fascinating, the shit that goes with it in the UK is the reason that medics are leaving in droves.

I do think It's a good career. The money's good and It's very secure with good holiday, pension, sick pay and flexible working once qualified. Consultant pay is £76k to £120k and after a few years supplemented by private practice. One of the few professions left where it is v difficult to be dismissed and where legal representation is allowed at disciplinaries.

The problem is that the NHS is dysfunctional and has become incrementally more unfit for purpose since 1947. It needs to be reformed completely to mirror more glory the funding structures on the Continent and to stop being a sacred cow.

I'm sure things will get better when the NHS as we know it now disappears and is replaced with something more fit for purpose. The British problem is that we are supposed to be grateful because It's "free". It isn't. I refuse to be grateful for a service that is badly managed, badly delivered, does not respect patients' time and refuses to properly apologise for poor standards.

It isn't fair to compare if to investment banking. Bankers hours never reduce and the career for the majority is short lived by comparison due to politics or burn out. I was one once. My DH is a lawyer. Self employed. No pension, sick pay, holiday pay and staff and premises to maintain. Oh and no guarantee that clients will pay bills (they always do but not necessarily on time).

Academic question 're my children as they are principally liberal arts/linguists rather than scientists but equally DH counsels (excuse pun) against the law.

The NHS is far from broke and doesn't need replacement- it needs funding properly. It is currently much lower percentage of GDP than other much lower performing healthcare systems in other countries. The myth of a broken NHS is a political rumour spread by likes of Daily Mail.

Many specialisties can't supplement with private practice - ED, Palliative medicine nowhere. Obstetrics, Paediatrics, Gerontology and other area in very few places. Very little medicine takes place in private sector- it's too expensive. Independent hospitals cherry pick lucrative elective surgery on well patients. Those that offer cancer care have a much lower support system and safety net.

Yeah, my mum was really 'well' ( practically crippled) with a herniated disc when she had private surgery. NHS hadnt even done an MRI at this stage and had sent her for physio. When her leg started going numb I persuaded her to pay for a private scan- surgeon had her in the next day.

Many specialisties can't supplement with private practice - ED, Palliative medicine nowhere. Obstetrics, Paediatrics, Gerontology and other area in very few places. Very little medicine takes place in private sector- it's too expensive. Independent hospitals cherry pick lucrative elective surgery on well patients. Those that offer cancer care have a much lower support system and safety net
The only doctors I know, and I know many, at consultant levels who do no private work at those who are consultants in A & E and Acute medicine. Maybe palliative but I don't know any. The paediatricians have so much work they're all running waiting lists and referring to one another and whilst there isn't a massive amount of private obstetrics they're keeping very busy with their hysterectomies and general private gynae work. The oncologists all do lots of private work too and people choose them for wider choices of treatment, not to mention the private GP surgeries which are popping up absolutely everywhere for people who can't actually get an appointment with their NHS GP's. They're earning themselves stupid with private work.

I have a friend who is a head radiologist - she is the only one of her colleagues who doesn't do private - she doesn't believe in it! She is amazing....being a consultant for her is truly about helping people - not attaining a bullshit status. I really wish doctors were more like her!

I don't know any Gp's who do private work at all. And I know alot. Also there is a massive recruitment crisis in general practice. Posts in nice areas which 10 years ago would have had 20+ applicants now get none and lie empty while everyone complains they can't get appointments - because there is no one to offer them !!

"private work" doesn't mean being paid by the individuals you treat. Most private work means things like doing medicals for life insurance, being a witness in court, etc.

We need this. Or no one would ever be able to get life insurance, or enter a profession that requires a medical, etc. These things are not related to health care, and should not be paid for by the NHS.

Private work on things like work medical are a tiny amount of addmoney to GPs. Most don't do much and payment often goes into practice funds.
Most private hospitals are not registered to provide care to children so not sure where all the paediatricians would be working. I only know one that does any private work.
Oncology is increasing in private hospitals but majority of oncologists do not undertake private practice as the risks are too high and there are not the full back up facilities and support.
Private obstetrics is limited to a few centres. Most obstetricians do not regularly perform gynaecology in NHS so cannot offer it in independent hospitals.
Very few gerontologists, acute physicians, stroke consultants offer private appointments. There are very few centres that would offer PPs.

Why would you become a doctor for money ? Many many easier ways to earn a living.

Dh's colleague' wife is a private GP. A private GPs surgery operates within 10miles of us. I have been offered private maternity, seen many a private gynaecologist - my dcs have seen countless paediatricians....most consultants seem to do private work - no idea where you are getting your info from Crumbs1 when dh needed a medical done for insurance it was a nurse who conducted the very basic tests. A doctor does his very thorough annual medical but that doctor is full time private.

Hmm.

Both my children had grommets privately (NHS didn't consider necessary according to HV - both children had 8+ ear infections within 6-8 months and were constantly unwell. Grommetted at 15 and 21 months and both turned the corner immexiately)

Dd's later ear infections aged 8 had to be sorted privately.

Physio deemed unnecessary after childhood breaks on NHS effected enormous improvement after two private sessions.

GP refused to refer dd to an NHS endocrinologist when I wasn't satisfied with thyroid results which were within normal but at opposite ends of spectrum. Thyroid was fine but good I followed my instinct and paid. She had/has Addisons which fortunately was diagnosed before a crisis.

CAMHS refused support for active cutting and overdoses. NHS GP and CAMHS told us to get therapy off the internet. We found a private psychiatrist who treated her and diagnosed the neuro developmental disorder that lay at the root of her problems. Where we she be now?

No GP at our practice works full time. Every partner also does at least two private sessions each week at our local private hospitals.

Leafy Surrey here. The NHS is falling apart - certainly not available before crises that are avoidable.

I feel very blessed that we are well heeled. God only knows what happens go those who aren't.

I get the information from my work. Plenty of private gynaecologists but much less common to have private obstetrician. Very, very few centres are allowed to provide it.

The overwhelming majority of independent hospitals are not allowed to see children and even fewer are allowed to admit them. The requirements for seeing children re paediatric nurses, separate facilities etc make it not cost effective for the hospitals. There are a few places in larger cities but then tends to be surgeons seeing children for ENT problems etc.

Yes there are some private GP practices and agencies but not many yet. They do tend to focus on medical, insurance and expert advice work. Most NHS GPs don't do private work because of their contracts.

Totally agree it is not high status anymore. There is very little respect these days for the stress, training and sheer hard work that being a doctor involves. (Not a doctor myself). I know less about Law but would agree it is also lower status. I think professional jobs in general are not valued anymore.

And Crumbs1 - my friend is a consultant up north - she is the only one of her colleagues not to do private work...even in the stick my parents have seen private urology, gynaecologist, orthopaedics. I think it's pretty common. I don't know why it matters though. There's easier ways to make money if you are clever and hard working.

I think the difference is that nowadays respect has to be earnt. It is no longer and nor should it be automatic. I deeplybrespect three of the partners at my practice. The other partners not so much.

I agree it should be earned. My own opinion is that they have earned some of my respect for the training and responsibility they have taken to get to that point. Then they can either go up or down in my estimation.

I agree Ohtheroses I have come across too many crap doctors (quite a few fantastic ones too)...the title itself proves nothing!

I think one of the issues with medicine is the lack of autonomy - for years and years - around basic things like where you live and when your holidays are. I had to apply to a region - not a specific hospital - to specialise. At the time when I did it you had to accept a job from the region - not a hospital or even a city. accepting a job from the region could have meant ending up anywhere in london Kent Surrey or Sussex, or anywhere between Suffolk and kings lynn, or 'north Scotland'. The first time you get to apply to a specific job in a specific hospital with a specific job description is as a consultant.
Most on call rotas are designed in advance of a post. you arrive at a new job as part of your SHO or registrar rotation and are told when your holidays are and what weekends you're working. Even if you're in the same place for a few years the rota is redesigned every six months and they give you as little as two weeks notice when your shifts are.
Regarding earning potential, no doctors aren't in it for the big bucks but a little more security would be nice. when you discover that you can barely afford a two bedroom flat within a decent distance to drive in to the hospital at night if you're on call from home after 6 years of med school, endless postgrad exams and in many cases a PhD and people who did three years of uni and seem to be able to relax at weekends and choose when they take holidays can, you start questioning the wisdom of your choices given that your end of school results probably gave you other options.
The actual job? It's amazing and is a privilege.
re names: I always ask patients how they would like to be addressed. A few like calling me 'Dr Pregnantgrump' for reasons of their own but the vast majority call me by my first name.

YY pregnantgrump. The lack of control over your own (and therefore your family's) life must be horrid. And frequently unrecognised.

A very good friend of mine, now an eminent consultant moved round the corner to me when she was 28 and took up a post at a major London teaching hospital. 27 years later she's a consultant there with a significant private practice as well. I don't think she's suffered as pregnantgrump suggests. I seem to recall manyvweekends when she was on call, paid and spent the weekend at home.

As a patient you only ever temporarily respect the title but you judge their ability, some times after just a few minutes Doctors can show how little they know - there's no high status for many - despite their success at secondary school, their inability is quite plain to see. So maybe it's high status if you can retain your enthusiasm for medicine but if your a fraud your patients will know.