Is medicine still a profession?
Authors: Kamran Abbasi
Journal: Journal of the Royal Society of Medicine (2009)

Is the profession of medicine in retreat? I’m reminded of this with September welcoming a new influx of medical students. A handful of them may be some of the wide-eyed enthusiasts who attended a meeting at the RSM earlier this year about why they should choose a career in medicine. Choose medicine, I said, because it is a profession that allows you to pursue many different paths, catering for the diverse personalities that constitute any medical school’s intake.

But I’m beginning to wonder if I misled them? Not just on the opportunities that will open up to them and only be limited by their own ambition and abilities. No, I’m questioning something more fundamental: the perception of medicine as a profession.

Doctors have traditionally embellished their day jobs with roles, for example, on medical committees, college councils, and faculties for conferences, meetings and training courses. Journal editors and associate editors are prime examples of doctors taking on an additional responsibility to their full-time role.

The advantages of these outside interests and positions have been considerable for individuals and for the organizations that employ them. The organizations gain greater influence, open themselves up to new ideas and alternative strategies, and can gain a competitive advantage. Doctors have considered that these additional responsibilities are an important differentiator between medicine as a profession and medicine as a factory job.

Yet times are changing. Clock-watching has become common place, with the European Working Time Directive being the most obvious example. More troublesome for many senior doctors is the issue of job planning, which is beginning to limit the additional roles and responsibilities that doctors can undertake. Organizations are becoming more corporate and less enlightened.

Most doctors will find a way round this new regime, but short-term petty-minded bosses are beginning to view doctors as factory workers. Their limited vision considers doctors to be dangerously independent, malfunctioning cogs in their wobbly healthcare machine, a species to be controlled and beaten into the shape of the appropriate widget.

Medicine was never meant to be governed by such tunnel vision, was it? Ultimately it will be the less enlightened organizations who will fail. These organizations will perceive little value in doctors spreading their wings and will treat them like factory workers, clocking on and off and filling in timesheets. Doctors in these organizations will begin to wonder whether medicine is any longer a profession when its practitioners are forced to cower before number crunches and bean counters.

To all of you feeling beaten up by the system, the JRSM offers you an outlet. This year’s December issue will contain a special feature, a series of 50-word submissions that answer the question: ‘What single change to your working life will restore your faith in medicine as a profession – and why?’ Non-medics annoyed by the thrust of this article can tell us what single change will allow doctors to be considered more professional. We will publish the best entries we receive and you can either e-mail me directly or submit via the JRSM’s online submission system.