04 March 2011

Deskilling Doctors

Last week I reflected on some of the problems with excessive use of imaging in medicine, noting in part that the trend spoke to wider issues of deprofessionalization in medicine. I know: old-fashioned language in the age of postmodernity! This week, however, historian of medicine John V Pickstone publishes a fantastic polemic in the BMJ that suggests how bad things have become under various regimes in Britain. He concludes:
Dogmatically inclined, unmindful of evidence, and casting about for mechanisms that might deliver quickly, recent [British] governments have proved easy prey to personal enthusiasms, management consultants, sectional interests, and the agents of private companies looking for business. Such were and are the conditions for political quackery, and thus “heroic” policy making is now ascendant. Though vastly better methods of service development have become available, and the future of a vital institution is at stake, the NHS is treated as if it were George III, when too distracted to reason.

Unless professionals, patients, and parliamentarians now call a halt—in the name of incremental development, refined empiricism, and proper public involvement—we shall remain in a land of policy quackery and political chamber pots. The NHS deserves so much better. Do not our politicians, like our clinicians, have a duty of meticulous care?


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    James Makker