Not a surgeon by instinct.

I read this excerpt from the excellent Jobbing Doctor Blog and have realised that after 30 years I am not an “instinctive” surgeon and am far better suited to coaching.

You could always tell the students in my year who were likely to favour surgery. They tended to be blokes, were more ‘flash’ than Jobbing Doctor, and looked at matters in a very logical and planned manner. They felt the need to ‘do something’. In that era (pre-ultrasound) they were very much of the opinion that if the history, examination and basic investigations did not give you the answer, then you best option was to proceed to surgery. Anything peculiar in the body they didn’t like, they removed it: their overriding epithet was:

‘If in doubt, chop it out’

Surgeons love modernity, and gadgets. They are always at the forefront of new technical developments in clinical medicine. New operative techniques (keyhole surgery, stents, endoscopic surgery) are their meat and drink, and I have always noted that surgeons tend to approach a problem with action rather than inaction, saying that non-surgeons tend to practice medicine by :

‘Pills, promises and post-mortems.’

Now I am sure that ‘Lord’ Darzi is a good man, and a gifted surgeon: but that is what he is – a surgeon. His knowledge of politics is partial, and his understanding of general practice is rudimentary. As a result of which, all that has come out of his review is worthy, laudable, aspirational and, unfortunately, not practical. When you find that people disagree with you, you can listen (which, to be fair, he has), but then make changes – which he hasn’t.

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