In September, several of us in the Faculty were sent a ‘Call for Evidence’ document by Health Education England (HEE) in which advice was sought from key stakeholders and partners to establish ‘what the NHS, patients and the public require from 21st century medical graduates’. We were asked to consider what the expectations of patients and the public will have of future doctors.
I am not sure that these expectations will change greatly from now. I anticipate that patients will still expect to be treated with respect and dignity by a competent, kind clinician who has empathy with them and establishes confidence and trust. While there may be a more multidisciplinary team working, ultimately most clinical decisions will continue to be made following discussion between an individual doctor and a patient. This is still likely to be face-to-face, either in a consulting room or via Skype, maybe in the evenings or at a weekend. More patients may come armed with a Google print out, maybe also with the sequence of their whole genome. Doctors will still need skills on sourcing appropriate evidence-based guidelines; critical appraisal of the available data and literature will be as important as ever.
There was an excellent book review in the Lancet last month by Michael Marmot, that I warmly recommend to you entitled ‘Winners take all’.1 In the article two books are compared. In ‘The Business of Changing the World’, by Raj Kumar, the author details how ‘billionaires, tech disrupters and social entrepreneurs are transforming the global aid industry’.2 In the other, ‘Winners Take all’, Anand Giridharadas describes the future billionaire philanthropists using market principles to change the world not as the solution, but a symptom of the broken system that allowed them to be created.3 One figure quoted in this article particularly struck me, namely that in 2018, 26 billionaires had the same net worth as the poorest half of the global population, 3.8. billion people. We know that the world’s resources are not evenly divided; the gap between rich and poor is getting bigger; unequal societies are not healthy societies.
In thinking of what we expect from our doctors of the future, I am challenged to also consider how we can, and must, also take steps to reduce the global burden of disease. Reducing the causes of disease, reducing the huge inequalities within societies, including our own, must go hand in hand with us training and delivering doctors to meet future clinical needs.
1. M Marmot, ‘Winners take all’, Lancet 394: 819 – 820, Sept 7, 2019
2. The Business of Changing the World: How Billionaires, Tech Disrupters, and Social Entrepreneurs are Transforming the Global Aid Industry. Raj Kumar Beacon Press, 2019 ISBN 9780807059579
3. Winners Take All: The Elite Charade of Changing the World. Anand Giridharadas Allen Lane, 2019 ISBN 9780241400722