Doctor quits and gives 16 reflections on his time in the NHS

A doctor has posted his reflections on working for the National Health Service after he quit as a doctor.

Back in September the British Medical Association warned the NHS in England was short of an estimated 50,000 doctors ahead of what is expected to be one of the worst winters on record.

The BMA said that the number of doctors in England had fallen behind comparable European Union countries, with 2.8 doctors per 1,000 people compared to an EU average of 3.7.

It said that its research at the start of the summer showed that meeting this average would require scaling up the medical workforce by an additional 31 per cent – or an additional 49,162 full-time equivalent (FTE) doctors.

The latest data showed falling primary and secondary care doctor numbers pushing shortage up to 50,191 FTE doctors, it added.

With that worrying news in mind and the new Covid variant sweeping into the country, one doctor who has left the profession took to Twitter to reflect on his time working for the NHS.

Thread

Dr Yusef Smith’s thread is a must-read.

1. Recruit enough driven, intelligent people and they will heroically hold together an underfunded, duct-taped system.
— Dr Yusef Smith (@PropaneFitness) November 27, 2021

2. Nurses are top bants & impressively tough.

I can’t fathom what keeps them going.

They cardiovert you, intubate, perform CPR, administer IV meds, yet paid literal peanuts.

I’ve seen some patients treat them terribly (& then switch to best behaviour when the doc walks in).
— Dr Yusef Smith (@PropaneFitness) November 27, 2021

3. There is no such thing as a peaceful poo.

You WILL get 6+ phone calls when you’re at your most vulnerable.
— Dr Yusef Smith (@PropaneFitness) November 27, 2021

4. I have worked with inspirationally smart, competent colleagues.

Mindblowingly so.

It has taught me to raise my standards in my own work.
— Dr Yusef Smith (@PropaneFitness) November 27, 2021

5. You aren’t paid your worth in healthcare.

£1800/month for my hours isn’t enough to keep me here.

Apply the same time, energy & training to other fields, and you’d see 10x the return.

There’s easier ways to earn £1800 without 7+ years of training/exams/sweat/nightshifts.
— Dr Yusef Smith (@PropaneFitness) November 27, 2021

6. Americans don’t get it.

Over here, the financials are completely removed from our individual clinical decisions.

I can say that with absolute confidence.

See point 5. We aren't paid enough to shill for big pharma 🧑‍🌾.
— Dr Yusef Smith (@PropaneFitness) November 27, 2021

7. The technology is worse than I’d ever expected.

Wrestling with fax machines & using a battered windows PC with a broken keyboard all day is enough to drive anyone insane.
— Dr Yusef Smith (@PropaneFitness) November 27, 2021

8. I made an astonishing discovery: beeping alarms, interruptions & sleep deprivation are not conducive to clear thinking or clinical decision making 👀
— Dr Yusef Smith (@PropaneFitness) November 27, 2021

9. “But we’ve always done it like this” is not a satisfactory excuse for a broken process.
— Dr Yusef Smith (@PropaneFitness) November 27, 2021

10.

10. There is a weird taboo around financial incentives in healthcare, as if its somehow exempt from the laws of supply and demand (see below).

Yet it would solve the discharge letter problem instantly.

A fiver would do it. Hey, even a parking pass.. or lunch. pic.twitter.com/ZwnMF2n1e4
— Dr Yusef Smith (@PropaneFitness) November 27, 2021

11.

11. I have learned the importance of user interface.

Every extra click, or 5 second delay creates an avalanche of organisational friction.
— Dr Yusef Smith (@PropaneFitness) November 27, 2021

12.

12. Time is SO valuable.

Most employers take the mick with it.

Being a doctor is not a full time job.

It’s probably 1.5x once you account for the actual hours PLUS the bandwidth, personal life + circadian disruption from night shifts etchttps://t.co/JJk4GLbuga
— Dr Yusef Smith (@PropaneFitness) November 27, 2021

13.

13. Junior docs do more adminning than doctoring.

It’s a blessing in the early stages, but seems like a strange way to allocate the system's highly trained human resources.
— Dr Yusef Smith (@PropaneFitness) November 27, 2021

14.

14. If nurses were allowed to prescribe paracetamol, we'd receive 90% fewer phonecalls.
— Dr Yusef Smith (@PropaneFitness) November 27, 2021

15.

It’s been a ride, and I’m sad to leave.

I will probably return.

The system is showing signs of failing – by the time I’m back it’ll have been packaged and sold off.
— Dr Yusef Smith (@PropaneFitness) November 27, 2021

16.

I’d return immediately if, (unthinkably):
– We could use Apple computers
– We were adequately compensated

But we needn't worry about such a radical shift happening any time soon.

Thanks for reading.

Follow, heckle, DM me your abuse etc. 🙏️💙

bye x
— Dr Yusef Smith (@PropaneFitness) November 27, 2021

He then replied to his many comments about his thread with…

Big response, thank you.

To clarify:
– I still love NHS: leaving because other projects need my attention.

– The comment about salary rustled some jimmies. £1800 is NET & I don’t mean to seem ungrateful.

It’s a good, secure living. But CHUNKY tuition debts & the ROI is low.
— Dr Yusef Smith (@PropaneFitness) November 28, 2021

Tags: NHS

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