‘Doctors Dissected provides valuable and startling insights into how doctors think. But the book is more of a philosophy, a wide-ranging meditation upon the meaning of medicine and what we are losing in a target-driven NHS. The doctor and columnist Martin Scurr, and the psychotherapist Jane Haynes, have conducted lengthy interviews with doctors, mostly GPs, about why they went into medicine, how they cope with making what can be very lonely decisions, and how, in some cases, they have dealt with their own illnesses (usually not well).
This is a deeply human, searching book, whose interviews roam far and wide in response to the life story of each doctor. Most of those interviewed are humble about what they do. “To become a patient is to fall into one of the most vulnerable states there is,” says one. Another believes that “being a doctor provides a very privileged way into suffering”.
The book is etched with the pain and regret of highly trained professionals who no longer feel able to give the kind of care they would like. Some have left the NHS for private practice, because of the bureaucracy and the inability to give continuity of care. The book claims that most GPs have only about 24 hours of patient contact time a week: the rest is spent in administration and box-ticking.
The most powerful sections are by Scurr. He seems to be one of those old-fashioned family doctors we all wish we had: the kind who will wake up in the night and write a note about a patient to check the next day. A specialist in end-of-life care, who was the first Medical Director of St John’s Hospice, he writes forcefully about the importance of knowing someone’s medical history, and being intimately familiar with the patient. “There is little use to the examination,” he says, “if a different doctor undertakes it each time.” A different doctor will not be able to tell what has changed. Nor will a different doctor have the confidence and trust of the patient that is so vital.
The upsurge of homeopathy and complementary medicine, Scurr believes, reflects our deep hunger for “quality time, a listening ear, care and sympathy from someone who they believe to be professional, skilled and committed”. In today’s NHS, the ending of GPs’ out-of-hours responsibilities means their “duty of care will end with the appointment of a locum”. He argues that there should be “incentives for doctors who care for their own patients and families and who personally know their histories”. Amen to that.’
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