A missing throat pack
A missing throat pack
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缺少喉咙包
DOI：
10.1046/j.1365-2044.2001.01976-19.x
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发表时间：
2001
期刊：
影响因子：
10.7
通讯作者：
M. Chan
中科院分区：
文献类型：
--
作者：
E. To;W. Tsang;F. Yiu;M. Chan
阅读威拉茨博士的社论，鼓励我们的专业在未来做出更大的努力，最初引发了一种熟悉的旧感觉，即我(大概还有我的同事)应该做得更多。幸运的是，这种情绪很快就过去了，取而代之的是一种怀疑和相当令人惊讶的愤怒(因为我认为我天生就是一个平静的人)。从首相那里传出的五个P的声音，正如人们可能预料的那样，就像是更多的政治声音片段。这句话出自一位资深的杰出同事之口，而这位同事可能会代表“工作面”的观点，这令人颇为惊讶。作为一个大型科室的临床主任，我刚刚签署了37位顾问同事的工作计划。所有人的工作时间都超过了欧洲的工作时间指令；这就是所谓的三个半小时的硬性会议。所有人都会同意，病房护理水平不足和高度依赖床位不足是他们想要实现的目标的限制因素。绝大多数人还不到40岁，肯定不是“保守和传统的”。他们当然不是“保护主义者”，而是富有想象力和热情，尽最大努力为长期资源有限的病人提供人员和设备。至于简单的“排气”，协会和皇家学院最近的活动快照显示，在任何时候，我们中有50%的人都在从事其他临床活动。威拉茨博士提出的乌托邦解决方案，即更大的工作灵活性和放弃正常的工作方法，本身并不足以拯救NHS。事实上，传统医疗实践的“坚如磐石”可能是支撑它这么长时间的唯一因素。无论未来如何，很明显，不能指望咨询公司工作得更努力、更长时间或更少的支持。教学、备课、评估、评估、再验证、继续医学教育、审计、风险管理、研究、CEPOD、投诉和许多其他方面的工作都必须留出时间。从本质上讲，适可而止。对于我们这些没有获得更高奖励、退休前还有很多年要工作的人来说，前景确实是黯淡的，很难说是机会之灾。哦，我刚刚又想到了一个‘P’1⁄4，这是一个不错的薪酬奖励。
Reading Dr Willatts' editorial exhorting our specialty to even greater efforts in the future initially provoked the old familiar feeling of guilt that I (and presumably my colleagues) should be doing much, much more. Happily this emotion soon passed, to be replaced with one of incredulity and, rather surprisingly (since I think by nature I am a placid fellow), anger. Coming from the Prime Minister, the five P's sound, as one might expect, like yet more political sound bites. Coming from a senior and distinguished colleague who might be expected to represent the views from the `coalface' they are rather surprising. As Clinical Director of a large department, I have just signed off the job plans of 37 consultant colleagues. All are working in excess of the European working time directive; so much for the `rigid three and a half hour session'. All would agree that inadequate nursing levels on the wards and inadequate high dependency beds are a limiting factor in what they would like to achieve. The vast majority are still under 40 and are certainly not `conservative and traditional'. They are certainly not `protectionist' but imaginative and enthusiastic in doing their very best for patients with chronically limited resources in terms of staff and equipment. As for simply `Passing Gas', the Association and Royal College recent snapshot of activity showed that at any one time 50% of us are engaged in other clinical activities anyway. The Utopian solution that Dr Willatts proposes of greater working flexibility and the abandonment of normal working methods will not by themselves be enough to save the NHS. Indeed, the `rock' of traditional medical practice may be all that has held it together for so long. Whatever the future holds, it is clear that Consultants cannot be expected to work any harder, or longer or with less support. Time must be given for teaching, lecture preparation, appraisal, assessment, revalidation, CME, audit, risk management, research, CEPOD, complaints and the many other calls on their time. In essence, enough is enough. For those of us without a higher award and with years left to work before retirement, the prospect is bleak indeed and hardly one of `Opportunity Knocks'. Oh and I've just thought of one more `P' 1⁄4 it's a decent Pay award.