GPs are not ‘things’

[摘要] ‘People are not things’  is a memorable mantra, sometimes attributed to the late Lord David ‘Rambo’ Ramsbotham (1934–2022), a former British army general and outspoken chief inspector of prisons. The aphorism is highly appropriate to this month’s Life &Times, set amid the strikes of nurses and paramedics, with the potential of more doctors’ strikes to come. Given some of the recent public rhetoric about GPs, I wonder if we are perceived as ‘things’, to be manufactured or bought-in and deployed where needed, as a means to cheap health care, without considering that we are also people with personal lives, families, and citizenship, or even basic human rights.In this issue David Zigmond argues that mass-produced doctors risk becoming commodified, with work stripped of human connection and meaning. These are essential to a flourishing practice in a literal sense. Without meaning and connection, work becomes robotic, even hollow.ARE GPs ‘ECONS’? If we are not ‘things’, GPs might be portrayed as examples of ‘homo economicus’, or ‘economic man’, sometimes called ‘Econs’, the rational self-interested person that classical economic theory assumes we all are. ‘Econs’ naturally aim to minimise work and maximise gain, and one can see how this might play into the false narrative of work-shy GPs avoiding face-to-face consultations.Cambridge primary care professor Martin Roland playfully demonstrates the dangers of adopting purely economic values and financial incentives: GPs with lists might do as little as possible for as many people as possible; fee-for-service GPs might maximise profit by doing unnecessary or unduly expensive work; and those incentivised by evidence-based targets might do this to the exclusion of all else. As many recent economists have accepted, however, people are generally not ‘Econs’. I would argue GPs still have a sense of idealism that renders them susceptible to moral exploitation.

[学科分类] 卫生学