I've been talking with managers at work about psychiatrists. Rather a lot, of late. I work in the NHS, changes are afoot, changes are always afoot. I talk with endless folk, endlessly, because it allows me protect my corner and be left alone to do what we do best. All that seeing patients and making things better malarky.
Managers have a different agenda. They usually are not thinking about the personal and privileged relationship a doctor or nurse, in a room with a patient, have, and how management can make this work best for one and all. Many years ago, that's what I imagined managers did. Now I remain buoyant and optimistic but I'm not so naive.
As an aside, Professor Sir Bruce Keogh, Medical Director at the Department of Health, does seem to have his finger on the pulse. The Jobbing Doctor feels, as many medics do, that our Chief Medical Officer has much to be contrite over. I am heartened that Bruce Keogh was saying how everything managers do, all systems that are in place, should be to improve the quality of that privileged moment of a therapist and their patient, in a room together, getting help. Superb!
Most weeks I speak with managers in our organisation, in neighboring FTs and with the PCT. The LMC and APC like to shred Consultants in Secondary Care too. The role of psychiatry in undergraduate teaching is modest, discussions I have with the university policy makers as an old age psychiatrist are laughable. But I enter the lions' dens time and time again because if I didn't I'd get sold down the river and life for me, our teams and my patients what be a whole heap worse.
I've also undertaken formal investigation of rubbish psychiatry in a neighbouring area. As well as middle grade doctors who've needed performance management, it got worse than that. Always grim, to see practice by a Consultant that's beyond poor and in to utterly shameful.
With patients, commissioners and staff I find myself increasingly having to justify the role of a Consultant Psychiatrist. In my corner, oddly, Old Age services are well regarded by all parties, so the knives are out for colleagues. Therein lies another post.
Suffice to say, we live in interesting times.
Normally, when a crowd get together and pool decision making, decisions are better. Sources of bias and error are cancelled. Guess the weight of a jar of sweets. You'll guess wrong. So will most folk. But use the crowd's answers and pool the answers, take an average, and you'll likely get close. Still not right, maybe, but better than the guess you'd have made yourself.
It was of interest to me, then, to see that this "wisdom of crowds" effect got worse when you gathered 300 psychiatrists together. Read about it here.
My managers will love this . . .