« The conservative case against inequality | Main | A witness on the kill floor »

Social justice
12 June 2012

Dr Scargill will see you now

Last month, Britain’s GPs voted to go on strike. Though industrial action by doctors is rare in this country, the vote was a reminder that professional bodies like the British Medical Association can easily rival the old National Union of Mineworkers for sheer self-interested obstinacy.

However, there are signs of a global challenge to the privileged position that doctors enjoy. This might seem counter-intuitive because, as we all know, demand for health care is increasing. But, that, according to the Economist, is precisely the point:

  • "…this demand… looks unlikely to be met by doctors in the way the past century’s was. For one thing, to treat the 21st century’s problems with a 20th-century approach to health care would require an impossible number of doctors. For another, caring for chronic conditions is not what doctors are best at. For both these reasons doctors look set to become much less central to health care—a process which, in some places, has already started."

Those places include India, where limited resources mean that the country has no choice but to pioneer new models if it is to expand the availability of health care:

  • "Your correspondent recently watched Devi Shetty, chief executive of Narayana Hrudayalaya hospital in Bangalore, making careful incisions in a yellowed heart, pulling out clots that resembled tiny octopuses. It looked difficult. Some of the other tasks at Narayana Hrudayalaya hospital do not, and are not. Dr Shetty’s goal is to offer as many surgeries as possible, without compromising on quality. To do that, he ensures that his surgeons do only the most complex procedures; an army of other workers do everything else. The result is surgeries that cost less than $2,000 each, about one-fifteenth as much as a similar procedure in America."

But won’t reducing the role of doctors be bad for patients? Apparently not. In many cases, new technology can fill the gap:

  • "Britain has completed the world’s biggest randomised trial of telehealth technology, including gizmos from Philips. The study examined 6,000 patients with chronic diseases. According to preliminary results of a study by Britain’s health department in December 2011, admissions to the emergency room dropped by 20% and mortality plummeted by 45%."

In other cases, appropriately trained nurses can do just as good a job:

  • "A review of studies of nurse practitioners in Britain, South Africa, America, Japan, Israel and Australia, published in the British Medical Journal, determined that patients treated by nurses were more satisfied and no less healthy than those treated by doctors."

In other words, like any other human activity, innovation can produce better results with fewer resources. We’ll just have to hope that Dr Scargill doesn’t stand in the way of progress.


You must be logged in using Intense Debate, Wordpress, Twitter or Facebook to comment.

Register to get The Deep End delivered to your inbox.