You know you are getting old when the junior doctor approaches you and your first thought is: ‘Ah, the school holidays have started.’ If you are over tired you may ruffle her hair and offer her a lemon Bon Bon.
Or ask him who his favourite Power Ranger is and wonder if Father Christmas brought him that toy stethoscope he is twiddling with. In short, you will think they are aged 11 and wonder where their parents are.
But no, they are the future of medicine a heady mix of youthful enthusiasm, natural anxiety and occasional raw arrogance. And, up to two weeks ago, they were going to be camping near the ward, and relying on you an awful lot, for up to 100 hours a week.
‘It is hard to see how patients’ best interests are served by post-pubescent medics who are desperate to curl up for a nap while you read them a story’
We have known for over a decade that junior doctors were going to have their hours restricted to 48 hours a week because of the European Working Time Directive and yet, when the ruling finally arrived, the murmurings of discontent ranged from concerns over managing swine flu to worries over the quality of training these part-time whippersnappers are going to get.
The truth is if the NHS cannot cope without making junior doctors work more than twice the hours it is deemed safe for a bus driver to work, there is something terribly wrong with the health service. And, frankly, while some senior medics suggest that patients will suffer because of those fussy Europeans, it is hard to see how the best interests of patients are served by the delirium of post-pubescent medics desperate to curl up for a nap while you read them a story.
Maybe part of the reason senior doctors are unhappy with the change in juniors’ hours apart from the obvious implication that they are going to have to work more is the challenge to the long-established cultural initiation that involves working a month without sleep and living on pot noodles and very strong coffee. You don¹t arrive in doctor world until you have been worked like a dog. Until you have proved you are made of the right stuff, and the right stuff is measured not in talent but in hardiness. It always struck me as the equivalent of training an Olympic athlete and testing them by entering them for It’s a Knockout. We know you are a finely honed athlete but can you dress up like a giant banana and swing across the pit of foam faster than the Dutch junior doctors?
The ritual of pain that is the traditional lot of the junior doctor isn’t necessary or helpful.
It is disingenuous to suggest that patients will suffer if they don’t have access to a junior doctor who has gone 17 hours without rest. We know we can do better than that. We know that the New Ways of Working offer creative ways of meeting patient need without relying on old models of care or even old unhelpful habits.
Roles can be developed to cover the space left by overworked junior doctors and so one wonders if part of the reason some doctors are unhappy with the civilising of working hours is about the power and autonomy of medicine being challenged rather than the well-being of patients or services.