A LEADING Scottish doctor has called for the title of “hospital consultant” to be dropped – saying it does not reflect the modern NHS.
The suggestion by Mr Ian Ritchie, the outgoing president of the Royal College of Surgeons of Edinburgh, is likely to be controversial as the label is prized by many doctors for marking the pinnacle of their training.
However, Mr Ritchie has called on his colleagues to consider a new name for fully qualified medical specialists.
In his last article as president for the college’s magazine Surgeon’s News, Mr Ritchie said “the term ‘consultant’ seems anachronistic and does not truly represent our role, making that role, and the role of those who are not badged ‘consultant’, unclear to our patients.”
Mr Ritchie explained when the NHS was founded in 1948 there was a hierarchy with the consultant at the top and said this had almost become part of the DNA of the service. “The way people think about things has not changed sufficiently to accommodate what is happening today,” he added. “If you asked most trainees or surgeons what becoming a consultant represented to them they would say ‘I will be autonomous, in control of my life, I will be able to organise myself in a way I cannot as a junior doctor.’”
However, Mr Ritchie said the priority for consultants should always be helping the NHS best meet the needs of patients. Both the growing elderly population and a shift in patient expectations, means these needs have changed. Mr Ritchie said: “The pressures on the system are so different to what they used to be in the past. Patients are not as passive as they used to be…
“The principle is we need to be much more about what our patients’ need. We need to ask: how do we organise things for the benefit of our patients? It is patients first, and then we need to think about ourselves and our colleagues in terms of making sure the way we work does not make us so tired and inefficient and irritable, so that relationships with our colleagues fall down.”
Mr Ritchie has been president of the RCSEd for three years. During his reign concerns have been raised about the way staff treat each other in NHS Grampian, with allegations of bullying, and in the vascular department of Edinburgh Royal Infirmary, where the consultants were found to be spending time actively looking for errors in each other's work.
Mr Ritchie pointed out that the number of consultants has increased significantly over time, saying this also means the notion of a pyramid with the consultant as chief at the top is no longer appropriate. In Scotland the number of consultants has increased by 1749 since 2002 to almost 5000.
In his article, Mr Ritchie calls on his colleagues to define what is meant by the term “consultant” these days. However, he is not offering an alternative title beyond suggesting it might be different for different types of doctor, such as surgeons and physicians.
He admitted axing the prized consultant badge could be “somewhat controversial” noting: “Many of us cherish the term because it took us so long to achieve that status, and I know our colleagues in training aspire to be consultants.” However, he also said efficiencies and improvements to patient care might be possible with a less traditional view of the consultants role.
A surgeon from Ninewell Hospital in Dundee, Mr Mike Lavelle-Jones, is taking over as president of the RCSEd.
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