In this blog, Dr Andrew Lansdown, regional adviser for south-east Wales puts the service pressures in the context of the progress made on improving population health. He reminds colleagues why they practise medicine at a time of growing patient demand and limited resource. He also pays tribute to former RCP vice president for Wales Dr Gareth Llewelyn.
Dr Hilary Williams is on leave.
Keeping things in perspective
As we survey what is a challenging medical landscape in 2024, it’s important that we maintain a balanced view. Over the past 50 years we’ve made great strides in specialism, chronic disease management and public health interventions. This progress means that more people are living longer, healthier lives; more survive diseases like cancer; and more people with health conditions are living more independent lives.
Public health interventions like smoke-free laws, flu vaccinations for children and older people, and the junk food advertising ban have also helped drive those outcomes, and there’s more to come.
The UK government recently introduced legislation to protect future generations from the harms of smoking. This means, if the bill is passed into law, anyone born on or after 1 January 2009 will never be legally sold tobacco products. With smoking contributing to some 80,000 deaths a year across the UK, this is a significant intervention.
However, with this progress comes additional pressure on a health service that was first designed for 1940s Britain. Recently, the National Centre for Social Research found that satisfaction with the NHS is at its lowest since the British Social Attitudes Survey began in 1983. Common themes for dissatisfaction include no new contenders – waiting times for GP and hospital appointments (71%), staff shortages (54%) and insufficient government spending (47%).
Despite these growing demands, workforce pressures and NHS infrastructure – including IT infrastructure – has not kept pace. Recent figures from the British Medical Association (BMA) showed that NHS doctors waste a staggering 13.5 million hours per year rebooting computers and staring at loading screens. More funding is clearly needed to sustain and equip a health service fit for its time, including long-term planning for the workforce that the health service and our communities need now and in future.
It can often be overwhelming to hear these surveys and statistics, and it is easy to lose perspective, both on the progress we’ve made and what it truly means to be a physician.
Back to basics
In January, I joined a lunchtime meeting entitled ‘Striving to be a better physician’.
It was a great opportunity to get ‘back to basics’ and reflect on important aspects such as: what makes a good physician? Who defines this? The love of medicine – is it just ‘a job’? Is medicine an art or science?
The talk was made up almost entirely of quotes from eminent physicians from past centuries. I can sum up the impact of being reminded of such words in the words of Hippocrates himself, who said ‘foolish the doctor who despises the knowledge acquired by the ancients’.
One of the most quoted physicians was William Osler (1849–1919), a Canadian physician who is often described as the father of modern medicine and one of the greatest diagnosticians to wield a stethoscope.
Some of the following Osler quotes are worthy of consideration:
‘The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head.’
‘The good physician treats the disease; the great physician treats the patient who has the disease.’
‘Listen to the patient, he is telling you the diagnosis.’
‘Acquire the art of detachment, the virtue of method, and the quality of thoroughness, but above all the grace of humility.’
These quotes can help to maintain our focus amidst the busyness and challenges of 2024. Taking a moment to reflect can bring us back to basics in our approach to patient care.
The glory of medicine
With ongoing workforce pressures, industrial action, and budget constraints, it can be all too easy to become downcast and weary.
However, we should do our best to remember how glorious medicine is. Glory is not often a word we hear these days, especially in relation to medicine. But to be a physician is something far greater than the ‘day-to-day’ grind of work. We are part of something greater and striving for the greater good; working alongside some great colleagues and having the privilege each day to meet great people – our patients. Another quote I came across said ‘sometimes I inspire my patients, more often they inspire me.’ Let this be so for us all.
Perhaps a final quote should come from of one of the seven founders of the Mayo Clinic, William James Mayo (1861–1939) himself:
‘The glory of medicine is that it is constantly moving forward, that there is always more to learn. The ills of today do not cloud the horizon of tomorrow, but act as a spur to greater effort.’ May we all be encouraged to see once again the glory of medicine in 2024 and may it spur us on to greater effort this spring.
Tribute to Dr Gareth Llewelyn
At the RCP, we were all devastated to hear that former vice president for Wales, Dr Gareth Llewelyn, died on Sunday 31 March following a short illness.
Gareth was a consultant neurologist based in south-east Wales. He served as RCP vice president for Wales between 2017–2020 and was honoured with an MBE for services to medicine in the Queen’s Birthday Honours in 2021.
For those of us who knew Gareth, he exemplified what it is to be a great physician, embodying the above quotes by Osler. During his tenure as vice president, Gareth led us with superb clarity and wisdom, taking the RCP in Wales from strength to strength. Little did any of us realise that his talk at our RCP update last November would be his last event with us. How apt, then, that he was given final place on stage, delivering an outstanding talk on functional neurological disorder, which we’ll remember with deep gratitude.
We’ll miss him a great deal; his sense of humour, his passion for medicine, his curiosity, creativeness and his strong commitment to supporting and developing the next generation of doctors. Gareth’s legacy in Wales will abide. Our thoughts are with his family at this difficult time.
And finally...
Please keep in touch with us at RCP Wales – we love to hear your views and we will continue to ensure that your voice is heard loud and clear at the RCP. Wishing you all well this spring.
Dr Andrew Lansdown
Consultant endocrinologist
RCP regional adviser
On behalf of the RCP Cymru Wales Team