Posted by: Witch Doctor | May 14, 2011

Trying to cook the future

The Witch Doctor has cast the difficult spell that makes her young again as she looks back on her life and at the same  time refreshes her ageing brain so she can harness the power to look into the future.

Once upon a time, after her Junior House Officer posts, when The Witch Doctor was applying for one of three SHO posts on a rotation scheme in the specialty of her choice, long before the days of MTAS, she found herself sitting outside a committee room with some other doctors from her year, waiting to be interviewed.

As was normal practice, after the interview we all had a confab about what questions we were asked.

One of the male doctors reported that he was asked where he thought he would be professionally in 15 years time (quite a common question then).

This was long before the “Futures Culture” had surfaced.

This doctor had a firm answer to the question. He said he would be a professor within his specialty.

The rest of us thought this a rather immodest if not arrogant answer and we told him so!

Funnily enough, he was appointed to one of the posts and within fifteen years he was a professor.

Now the question is, did he predict the future, or did he make the future happen?

He made the future happen, of course. Nothing, absolutely nothing, got into the way of his professorship. He worked very hard, did all the right things at all the right times, genuinely impressed all the right people and he made it to the goal that he prioritized in life beyond all else.

There’s nothing wrong with that. He earned his early professorship as he said he would. It is seldom that a doctor becomes a professor purely because of luck or without planning for that role.

However, the same is also true of ”medical politicians.” They do not get there just by chance. They orchestrate their lives to meet their goal. Therefore the public should not assume medically qualified  advisors / administrators / managers / politicians within the NHS are necessarily the best doctors. They should not assume their medical peers regard them as their “bosses” or respect them because of their political gamesmanship. A doctor in clinical practice generally respects another doctor because of their clinical skills, research skills, or educational skills in varying amounts. Nothing else counts much. Also, they know those medical monkeys who can negotiate the political trees are clever. They know what they have to do to ensure the ascent. Most hands-on clinicians are indifferent to these skills these colleagues demonstrate, unless of course they are persistently left holding the clinical baby on behalf of the medical monkey half way up a tree while trying to make their future happen. Then they moan about them, and the extra clinical work they have been left to do on their behalf. They might even regard them as no more than agile medical pests.

My Black Cat is just beginning to discover the importance of these agile medical monkeys to governments, industry and ultimately to the global economy. She says governments and industries nowadays do not consider these useful agile monkeys as pests because they have a very important role to play – to make the future go according to plan. These medical “politicians” are needed because only they can nudge encourage the medical profession and patients into accepting cheaper and more profitable healthcare.


Incidentally, when The Witch Doctor was interviewed for one of these rotational posts she wasn’t asked where she thought she would professionally be in 15 years time.

Indeed no!

Instead she was asked if she intended to get pregnant!

They’ll be wondering how The Witch Doctor answered that question, My Black Cat.

They’ll be wondering too whether or not she secured one of the posts.

We’ll not tell them.

They’ll have to guess.

Eh, My Black Cat?



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  1. I have been asked that question about the future many times and I have ended up exactly as I predicted. Not at all easily I might add. I made the future happen – against all the odds as it turned out.

    The reason why I chose to do what I am doing is that I always had a high regard for those that do what I now do. Seeing people able to deal, apparently easily, with a sick patient, a diagnostic problem or a difficult clinical situation always impressed me. I wanted to make myself into one of those people I admired.

    I never wanted to be a medical politician. They were not people I ever admired. But, as I have become older, I have realised that those of us at the coalface who despise our leaders have only ourselves to blame. The NHS will collapse all around us unless we seize the reins. So far my only slight influence on the way things are going has been through blogging but I am minded, if the opportunity arises, to take some more political role not for my career or self-aggrandisement (these people do not impress me) but because I want to make the future a little less bad that it might otherwise be. This last ambition will, of course, be dashed. I know that already. You need to plan these things decades in advance. It is too late for poor old Grumble.

    • One of the things that could be done immediately to “seize the reins” is for GPs and consultants to come together nationally, and in the interests of patient care, refuse to allow anything to intervene in the referral of a patient from GP to consultant. The fact that GPs and consultants allowed this to happen at all is a travesty and I know patients who have come a cropper over this ridiculous construct intitiated by management and supported, of course, by some of our esteemed medical colleagues who are climbing the monkey trees.

      This would need to be done throughout the country though, but would have a considerable effect very quickly.

      “Northern Doc” has just put up an excellent post today called “Watching the Consultants”

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