The only thing that is constant is change

By Robin Allum
Retired Consultant Orthopaedic Surgeon

Below is a reflection of my experience and insight into my NHS career on a personal basis, based on observations from over 50 years in healthcare.

Firstly, the only thing that is constant is change and the following will reflect this.

I am happy to say that I had a richly rewarding career in the NHS from qualification on 30th June 1972 until retirement on my 65th birthday on 31st December 2013.  I have absolutely no regrets.  Never for one moment would I have thought of leaving medicine.

I was not particularly bright academically.  In 1967 I obtained a place at Bristol Medical School with a B and 2 C’s.  As a house officer in 1972 I worked 100 hours a week (1 in 2).  Two of us ran two wards for six months at a time.  My salary was £90/month.  I looked after my patients as they were my patients and, indeed, if I was concerned, then I would often call in on my night off to see them.

Sure it was a huge commitment, but I felt valued and none of my colleagues (to the best if my knowledge) felt otherwise.  This continued through my training years.  I just had the best time.

Work/life balance was total work satisfaction, then if time allowed other activities.  I had no idea what ‘burnout’ was or might be.

I moved forward to a very satisfying career as a Consultant in Knee Surgery.  I worked all hours that my patients wanted me to and yet along the way was Honorary Secretary of the BOA, President of BASK, Regional Adviser Oxford Region, Editorial Board JBJS as it was then; very happy family life, three daughters, five London Marathons – including for Wishbone, 100 Half Marathons, hockey at county standard for Gloucestershire, single figure golf handicap, MCC member and recently walked the Pennine Way.

It seems counterintuitive to me that a reduction in hours from 100 to 48 has increased stress and dissatisfaction, but this is undeniably the case.

So my message is that long hours in medicine do not preclude a fruitful life outside medicine and almost certainly will give a fruitful life inside medicine.

I would just add that most important issue facing us now is ownership of the failing healthcare system for our patients, and this is far more important than the cultural side issues that seem to currently plague us and occupy so much of our time.  Patient care should be our focus.  I, of course, accept that there will always be such cultural issues, but at present our focus does seem to have been diverted.  Look outward, not inward.  Please.