Posted by: Witch Doctor | April 6, 2011

Doctors : Brilliant though they are…….. (Updated)


N.B. See update at foot of page.

On the day that The Ferret Fancier is having apoplexy over rationing of “care” for painful, debilitating conditions, The Witch Doctor can report there is a solution to all his concerns.

To hell with the art of medicine!

To hell with surgeons that perform hip and knee replacements!

To hell with pain!

Roll in The Business Schools!

Treat healthcare as a “complex system.” The MBA qualification is what we need. Not MB ChB.


None of this is quite as easy as you think, Dr Welbourn. There are a few small issues regarding patient care. One is called “diagnosis.”

Another is called “overall responsibility.”

The kind of responsibility for diagnosing and, in multiple chronic conditions, diagnosing  repeatedly  in addition to overseeing the care of every single patient as an individual.

The kind of responsibility that may propel a doctor into the courtroom and to the GMC.

Do you really think the medical profession have not considered all of the issues you have mentioned?

Do you really think doctors are unaware of the consequences of demographic change, advances in medicine, evidence base, the challenges of managing chronic disease at home, the cost?

Do you really think we are unaware that medicine is “a complex system?”

Indeed, have you ever stopped to consider that each and every patient is a “Complex System.”

Doctors are artists – not providers!

And it will always be so.

Indeed, it will become even more so as patients are more informed, exert true choice, and in so doing choose ask very difficult questions about their conditions.

Or choose not to.

The Art of Medicine, hand in hand with the science of medicine, will be in demand more than it ever was.

In the meantime, while we doctors are being artists, if the business schools can help in providing these individual complex patients with the simpler resources to keep them at home rather than in care they will be doing very well indeed. But be specific. Don’t just talk about teams. Think about things like bedmaking, toilet cleaning, oven cleaning, home and patient hygeine, shopping, washing, ironing, garbage disposal, putting household waste into numerous recycling bins and wheeling them out on to the pavement…….

You get the gist…….

In the meantime, remember that hip pain is disabling and much of the above support may be necessary for patients being denied surgery for orthopaedic conditions.

I suppose though, as soon as patients requiring orthopaedic surgery start to be a drain on society, they will be whipped into hospital…..

But then, as The Ferret says, the outcome may not be so good!

Ah, it is indeed a very Complex System.

Eh, My Black Cat?


P.S. By coincidence, I have heard of a 95 year old, who was receiving a lot of care every day from various “health care providers” in her own home, who did not have her bed changed for three months.

Healthwise, the 95 year old was in no position to change her own bed. This is one of the most difficult things for a frail disabled person to do.

Nobody noticed.

Nobody had it on their protocol.

Perhaps the Business schools could deal with “complexities” like this.

It would be a real help and would allow doctors to get on with being “artists” rather than spending time hunting around the house for clean bed linen when they visit their patients!

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  1. who the f*ck does that wanker think he is?

    not ignoring his disgusting clothing, his chat is based on nothing of substance, what does he think doctors are currently doing, ignoring the science and the evidence? what a fool

    ‘complex systems’ – no shit sherlock, no shit

    sounds like business bullshit to me, my witch!

  2. More:

  3. Is this the David Welbourn who is a Chartered Engineer and a Chartered Physicist and has a PhD in Electrical Engineering from Edinburgh University as well as a Bachelor’s and Master’s degree in Natural Sciences from Cambridge?

    Given this background perhaps he can be forgiven. Why didn’t he stick to what he knows about?

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