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The role of the doctor

Building on the past, looking to the future

Introduction
The Modernising Medical Careers inquiry’s recommendation to develop ‘a common shared understanding’ of the role of doctors formed part of what was a welcome response to the considerable shortcomings of the MMC project evidenced during the course of 2007. However, this simple call for greater clarity around the contribution of doctors in the context of the modern healthcare team disguises a very much more complex set of pressures currently in operation across the health care sector. These pressures, and likewise a number of key trends, necessarily impact upon the medical profession’s engagement with, and contribution to, medicine in the UK both currently and in the future. Together these provide a convincing imperative to explore the ‘role of the doctor’ as a concept.

This report draws upon previous work by the BMA in this area, and more recent thinking carried out across the Association on the role of particular cadres of doctors. In the first section of this report, the nature of these pressures will be addressed and, in concluding, how these require us to reflect on the two forces, ‘change’ and ‘constancy’, which together shape the role of the doctor. The following sections will explore the enduring values that provide an ever-steady platform upon which the medical profession can reliably respond to the challenges it faces. The importance of these values is reflected in the findings of recent research carried out by the BMA that allows us to shift the debate from one of abstract understanding and instead demonstrate the values’ relevance to current doctors and the public. Further exploration of these values will seek to illustrate how their combination underlies both an individual doctor’s practice as well as the distinctive contribution that doctors make to health care more generally. Consequently, in looking at the unique aspects of a doctor’s role, the discussion will be framed by an examination of not simply ‘what is it that doctors do?’ but, rather, ‘what is it that doctors do that others don’t?’ By gaining an appreciation of these particular exceptional skills and competencies, and the values that underpin them, the fundamental nature of the doctor’s role will be clearly illuminated.

In the final section, the current challenges facing the medical profession will be revisited and consideration given to the consequences of allowing change to unwittingly, or otherwise, erode the values that are at the core of what a doctor is and does. In confronting this possibility, the paper will offer its own challenge to those charged with the responsibility for safeguarding and harnessing these values to the benefit of patients, the NHS and the profession itself in the context of a complex and changing health care environment.

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