robinw... I'm (almost) speechless!
All Consultants have been Junior doctors, have put up with the sh*t, which mostly does not come from their Consultants. Arrogance is not something that is taught to doctors, it is an inbuilt trait that some people have. Yes, for some reason, it does seem to be more prevalent in surgeons, and men, but it is not universal. I'm really insulted!
Yes, some surgeons who have long waiting lists will be able to the same procedure in the private sector the next week. So what? Private practice is done in their free time! If the patient chooses to go private to jump the queue, does that make the surgeon a bad person? Are you implying that we deliberately keep the waiting lists long in order to fund our private practice? I've heard all that before, and its laughable! I would prefer that we didn't have a private sector at all, that the NHS could cope with all the health demands of the population, but it can't. The private sector is there, I see no problem with people using it if they want to. If they want operations, they must have surgeons to do them...I would far rather have a properly trained surgeon, who is subject to the regular educational scrutiny, appraisal and (forthcoming) reassessment, who also works in the NHS, than someone who can do what the hell he likes, because someone is stupid enough to pay him to do it. Cosmetic surgery is a prime example- did you see that Channel 4 programme recently? They had a girl, a single mother on benefits, who took out a bank loan to have a boob job, in order to get "glamour modelling" jobs. The photographer she went to see post surgery didn't think she had what it takes to be successful- so several thousands of pounds down the pan, and no way of paying it back! That surgeon should never have taken her money. It was criminal.
As for references for Junior doctors- well, I only give good ones. If I feel that someone is not suited to a career in surgery, I tell them. I try to make a reference as positive as possible, I know how demoralising it can be to have 10 interviews in a row, with no job at the end.
Our canteen does not have a separate area for Consultants, doctors or any staff. I wish it did. Last week, between clinics, I was eating my lunch, when a relative of a patient I had seen in the morning sat himself down at my table and tried to find out what we had discussed in the consultation. I have no idea where the patient was at that time, and doubted if he would have been happy to have his details discussed in public.I ended up having to leave my lunch, as I couldn't persuade him that it was inappropriate to accost me in this way. Nurses get this type of intrusion into their lunch and coffee breaks, too. We should have separate canteens for staff.
Of course, the managers, whose offices are not in the same block as the main hospital, have their own dining room, and have food sent up to them at lunchtime.
We could invite our manager to lunch (in fact next week we are spending a whole day with her, the Chief Exec, the Medical Director et al)but not much would get done in the half hour available. My point is that the managers job should be more shop-floor. If she was given an office in our department, rather than up the hill, and if we were able to interact a bit more we might see things improve.
I think a surgeon being injured by defunct equipment is actually a good reason to replace it.I would have been entirely justified in taking several weeks sick leave, but worked even with my hand in plaster. That doesn't make me a martyr, its actually less bother than trying to rearrange six weeks worth of clinics and lists. The NHS runs on good will, and for most of its staff it's pretty much run out.
As for new toys- the patients are demanding them! They come to clinics with articles cut out of magazines and newspapers, or found on the internet, and demand the state of the art treatment. If it is really state of the art, they should get it, but it is sometimes very difficult to persuade them that a new technique is not tried and trusted, and therefore not recommended for them. I recently went on a course to learn a new technique, which would make a certain type of operation quicker, enable the patient to be discharged from hospital sooner, with less pain and fewer complications. I'm still waiting to find out if I will be allowed the equipment. The managers can effectively dictate what treatment I give my patients, by deciding whether or not I can the euipment. Clinical freedom, i.e. the ability of a doctor to the thing that he or she feels best for an individual patient has gone out of the window.
That's enough for now