The title of this post changed many times. Trying to convey my thoughts on an ‘institutionalized professional’ may be challenging. Many professionals, specifically medical colleagues, will disagree with me on this topic. I accept that. However, if you strongly disagree with me, please let me know your thoughts in the comments and we can do ‘battle’ ?
Definition of Institutionlized
Institutionalized is a word that has been used in relation to many situations in the past e.g. https://en.wikipedia.org/wiki/Institutional_racism; https://en.wikipedia.org/wiki/Institutionalized_discrimintation.
The definition of institutionalized by the Cambridge dictionary is below
“If someone becomes institutionalized, they gradually become less able to think and act independently, because of having lived for a long time under the rules of an institution: We need to avoid long-stay patients in the hospital becoming institutionalized”.
https://dictionary.cambridge.org/dictionary/english/institutionalized
The Good Old NHS: The end-users
We all agree that the fantastic NHS is an institution envied by nations; providing health care at the point of need. Its workforce is wide and varied. It is a lifeline for patients, doctors, nurses, radiographers, cleaners, porters, pharmacists, technicians, managers; the list goes on.
There are patients who never utilize the NHS, some who utilize it sparingly. A few patients think the NHS is an amusement park that can be accessed at will?. I suppose it is like any other service except the NHS is free at the point of need which is unlike any other service?.
Some patients utilize the NHS so much that they become institutionalized. The majority of these patients truly have health problems thus need the expertise of the medical workforce in NHS. The minority do not and there is nothing we can do about that.
The Good Old NHS: The Medical workforce
Having discussed the end-users of the NHS, what about the ‘MEDICAL’ workforce: Are we institutionalized?? By the Medical workforce, I am referring to doctors, nurses, pharmacists, and the likes. Most of the medical workforce can take up jobs in any medical facility, work for the private sector, or go solo. It is not so for medical doctors.
The medical doctor’s career commences in medical school which is deeply rooted in the NHS. Training, postings, and examinations are delivered within the NHS. Medical schools and the NHS are deeply intertwined that it is one and the same.
Once medical school is over, the foundation and training years of a medical doctor are within the NHS. The option of working in a different establishment does not exist unless you make the conscious choice to leave the country. The NHS will be waiting for you when you return?. This also applies to those who went to medical school outside of the United Kingdom. The only option is the NHS.
Working in the private sector is a possibility. However, you need to have worked as a consultant in the NHS for 12 months to be considered. Some senior colleagues excelled in the private sector but ‘Lady Corona’ put a spanner in the works. Alternatively, resident medical officers (RMO) can also work in the private sector. This is a non-career grade post and not an attractive option.
Time spent in the NHS
Braking down time spent as below:
- Time in medical school: 5 years
- Foundation doctor years: 2 years
- Trainee doctor years: 7 years
- Total: 14 years
If one starts medical school at 18 years old, at 32 years old, they would have spent 43% of their time on earth in the NHS.
Let’s go deeper. Say one becomes a consultant at 32 years of age (hardly ever!!) and works for the NHS till retirement at 60 years old. That add on 28 years, bring the total number to 42 years in the NHS. In percentage, this is 70% of the individual’s time on earth ?.
For some medical doctors, this is where the story ends as they become institutionalized professionals without knowing it. Working for the NHS from dawn till dusk, from cradle to retirement and then to the grave. It was a one-way journey. No turns are taken along the way to explore additional options. Yet we wonder why some of our medical colleagues face the dreaded burnout.
Institutionalized Professionals
Having spent so much time within the NHS, It is very likely that medical doctors become institutionalized. We become less likely to make independent decisions. Making independent decisions is one thing, being allowed to execute those decisions is another. There is always a policy or a manager, within the NHS, preventing medical doctors from taking initiatives forward. After a while (I mean after many years) apathy sets in and we maintain the status quo till retirement.
The above was the SINGLE COMMON STORY.
The Balance of Stories
The medical profession is a prestigious one. The competition for medical school and training jobs is fierce. It provides job security irrespective of your background. We are proud of our profession.
Having said the above, Other professionals are able to work in different roles in the lifetime of their profession. For medical doctors, this is not the case. Our managers are not doctors. Doctors do not manage establishments in the NHS. Management is not included in the curriculum for most trainee doctors. This is the genesis of the problem.
We have to change the story for ourselves. If we cannot make changes within the NHS perhaps we can divert the time to ourselves. Lets us, medical doctors, live differently, let’s learn something new, step out of our comfort zone, out of our ‘institution’. We, too, can disrupt!!
Its time to change the single common story. We have to make our unique and individual stories. The popular saying ‘think outside the box’ is irritating to me. How about we breakdown the box and discard it?? When at work, give 110% of your time to Work. The rest of the time, outside of work, is yours and you cannot bank it!! https://thespearking.com/call-to-action-for-all-medical-doctors%f0%9f%a4%94/
Steve Jobs alludes to my line of thinking in the first point he makes in this video https://www.youtube.com/watch?v=eHzAtxW3TzY&t=1492s. Bless him, He made his mark disrupting an industry in a way we will never forget, leaving a legacy behind. We all need to do the same.
Take home message: What will you do next??
