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PostPosted: Wed Oct 10, 2018 4:26 am 
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My daughters and I had an interesting conversation about what Medicine might be like as a career in 20 years time. I would be really interested to hear what other think? These were some of the points that came up:

Surgery may be predominantly performed by robots. Robots will also perform many tasks in hospitals along side humans such as administration of medicines. Lifting patients from beds, cleaning.
Genetics will be important and medicine may be becoming increasingly preventative rather than curative. People will increasingly use smart watches/devices at home that link to their GP.
Regenerative medicine e.g. reprogramming at a cellular level will be big.
Cancer will no longer be the the thing that people fear most. Immunotherapy will personalised to fight diseases.

There won't be much point in following a career that is redundant. :lol:


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PostPosted: Wed Oct 10, 2018 6:25 am 
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Eccentric wrote:
People will increasingly use smart watches/devices at home that link to their GP.


they do already - in Yorkshire there are lots of elderly people with ipads linked to the telehealth system at the local hospital.

Code:
There won't be much point in following a career that is redundant.  :lol:


Quite, I agree. But then don't start me on the "the job isn't what it was" rant, I'll be late for surgery this morning - where most people just want to talk about their symptoms (or explain what the hospital doctors meant / did ) and that may just be the one thing that machines won't be any good at.


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PostPosted: Wed Oct 10, 2018 6:49 am 
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You have given a summary of the glamorous, sexy parts of future medicine there Eccentric, and some of it might well come to fruition.

When my daughter was the age your daughter is now, she also wanted to go into Medicine. She chose her A levels accordingly and was on track to (and in fact did) get the grades needed. She began volunteering (and still does) in a setting with disabled adults; she also managed to get work experience in a GP practice in a not very leafy area. Very soon she had come to the realisation that it would not be for her. This, in a nutshell, was because she did not see the future of medicine in the way you do, but in terms of managing chronic, debilitating (non-sexy) complaints in an ageing population, with little funding going into research to prevent them or into resources to manage them. Diseases of ageing such as arthritis; lifestyle diseases like T2 diabetes; the sequelae of obesity; dementia etc, which do not attract the high profile documentaries but are the reality of life in a GP practice. And that is before you even mention mental health, which she said accounted for or was a factor in over half the consultations she witnessed, but which is massively underfunded and not easily dealt with by a robot or a smartphone. Her view, which I think was pretty insightful at the time, was that medicine/science, has the answers to a lot of the health questions we have today, but because of the way resources are managed, or in which people act, these answers are not implemented. For her that was a seminal realisation and she turned her back on science and moved into an area where I think she might hope to influence policy instead.

So in short, I don't see Medicine in quite the way you do. If the progressive deprofessionalisation of teachers in our country is anything to go by, I see doctors becoming increasingly under pressure to manage ongoing, grinding conditions which are exacerbated by poverty, age and disability (and you only need to read of Melanie Reid's ongoing battles with indwelling catheter infection to know that even the most basic of personal needs do not attract funding or public attention), and to be the only source of comfort for people with a range of complex mental health needs. Sure, the glamorous stuff will go on too, if you are a surgeon or manage to get a job somewhere in the private sector or with private funding. But the NHS is going to collapse under the demands of an ageing population with mundane but demanding issues and I do not see the job of a doctor as squaring too easily with the humanitarian vocation many young people have, sadly.


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PostPosted: Wed Oct 10, 2018 6:57 am 
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Amber wrote:
You have given a summary of the glamorous, sexy parts of future medicine there Eccentric, and some of it might well come to fruition.

When my daughter was the age your daughter is now, she also wanted to go into Medicine. She chose her A levels accordingly and was on track to (and in fact did) get the grades needed. She began volunteering (and still does) in a setting with disabled adults; she also managed to get work experience in a GP practice in a not very leafy area. Very soon she had come to the realisation that it would not be for her. This, in a nutshell, was because she did not see the future of medicine in the way you do, but in terms of managing chronic, debilitating (non-sexy) complaints in an ageing population, with little funding going into research to prevent them or into resources to manage them. Diseases of ageing such as arthritis; lifestyle diseases like T2 diabetes; the sequelae of obesity; dementia etc, which do not attract the high profile documentaries but are the reality of life in a GP practice. And that is before you even mention mental health, which she said accounted for or was a factor in over half the consultations she witnessed, but which is massively underfunded and not easily dealt with by a robot or a smartphone. Her view, which I think was pretty insightful at the time, was that medicine/science, has the answers to a lot of the health questions we have today, but because of the way resources are managed, or in which people act, these answers are not implemented. For her that was a seminal realisation and she turned her back on science and moved into an area where I think she might hope to influence policy instead.

So in short, I don't see Medicine in quite the way you do. If the progressive deprofessionalisation of teachers in our country is anything to go by, I see doctors becoming increasingly under pressure to manage ongoing, grinding conditions which are exacerbated by poverty, age and disability (and you only need to read of Melanie Reid's ongoing battles with indwelling catheter infection to know that even the most basic of personal needs do not attract funding or public attention), and to be the only source of comfort for people with a range of complex mental health needs. Sure, the glamorous stuff will go on too, if you are a surgeon or manage to get a job somewhere in the private sector or with private funding. But the NHS is going to collapse under the demands of an ageing population with mundane but demanding issues and I do not see the job of a doctor as squaring too easily with the humanitarian vocation many young people have, sadly.

This is exactly the non sexy profile that I need to relate to introduce realism into my DDs dream life. However I also need to introduce the sexy stuff as alternatives too. I need to find some more enjoyable sexy sides of medicine that pay well and will not consume her life like a surgical career would.


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PostPosted: Wed Oct 10, 2018 7:05 am 
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Eccentric wrote:
I need to find some more enjoyable sexy sides of medicine that pay well and will not consume her life like a surgical career would.
With respect, why do you need to do it? Should she not be left to discover this for herself? She is only what, 15? I think you can probably trust her to do her own research in time to make the right decisions. :)

Anyway, what if there are not such sexy enjoyable lucrative pathways in Medicine? You can't make them for her, Eccentric. She may need to think elsewhere, if these factors turn out to be her priorities when she is old enough to decide.


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PostPosted: Wed Oct 10, 2018 8:09 am 
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Amber wrote:
Eccentric wrote:
I need to find some more enjoyable sexy sides of medicine that pay well and will not consume her life like a surgical career would.
With respect, why do you need to do it? Should she not be left to discover this for herself? She is only what, 15? I think you can probably trust her to do her own research in time to make the right decisions. :)

Anyway, what if there are not such sexy enjoyable lucrative pathways in Medicine? You can't make them for her, Eccentric. She may need to think elsewhere, if these factors turn out to be her priorities when she is old enough to decide.

I don’t want to turn this into anything other than what the thread started as. Interest in what people think the nature if medicine may be. We cannot pretend to understand one another’s DC whom we do not personally know or the intentions of their parents. As many others have many times stated in these threads we all wan the best for our children and sometimes that involves introducing alternatives into their lives. Sometimes we as individuals are not capable of finding those for ourselves because we are blindsided by what we perceive to be true.


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PostPosted: Wed Oct 10, 2018 8:11 am 
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Ouch.

Over and out then.


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PostPosted: Wed Oct 10, 2018 8:18 am 
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Amber wrote:
Eccentric wrote:
I need to find some more enjoyable sexy sides of medicine that pay well and will not consume her life like a surgical career would.
With respect, why do you need to do it? Should she not be left to discover this for herself? She is only what, 15? I think you can probably trust her to do her own research in time to make the right decisions. :)

Anyway, what if there are not such sexy enjoyable lucrative pathways in Medicine? You can't make them for her, Eccentric. She may need to think elsewhere, if these factors turn out to be her priorities when she is old enough to decide.


Most definitely +1


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PostPosted: Wed Oct 10, 2018 8:21 am 
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I don't think you're entirely correct in your assumptions.
I've been a doctor for 21 years and we thought we'd be facing quite a lot of those changes and it hasn't really happened. Robotic surgery was definitely coming in as I left hospital medicine and it's more prevalent now - but requires a skilled surgeon to operate it. Cancer survival is improving but the diagnosis and management of the aftermath is still difficult. People are living longer, cancer is going to be a very common cause of death for many more decades. We're not going to beat every cancer.
I think Amber's post is perfect about the realities of medicine right now - no need to repeat any of that. The reality is that 50% of UK graduates will go into general practice. The reality is also that GPs are haemorrhaging from the profession at an alarming rate (one leaves every 3 hours. Many are retiring early. Some are moving into public health and inform us with astonishment that they have time to eat and go to the bathroom in their day. Many are going to Australia, NZ or the new favourite Canada). Some of the se.x.ier specialties have a 1:8 or higher application rate. Many people never make it in their preferred specialty; still more change their minds. To go into medicine with the mindset of "I want to be a ...." is a risky thing because most people don't really know their skill sets at 18. You have to go in with the "I want to be a doctor and I really can't imagine doing anything wise with my life" attitude, in my opinion.
Things that have increased over the last 20 years and are set to get greater over the next 20 in my opinion?
1) Litigation. No win no fee lawyers are the bane of our lives. We get attempts to sue us fairly regularly. They are all absolutely hopeless cases but all take time (lots of time) and stress. Also it is really hard to have to keep seeing the patient who is suing you bit apparently remains happy to keep coming to see you regularly?
2) Entitlement. The "this is my third cold in three months and something needs to be done about it" attitude. The "my sore throat started this morning and I need it to be gone because I've got a party tomorrow" attitude. The "I need the NHS to deal with this because I paid my taxes" attitude.
3) Complaints. Lower level than the litigation stuff. Trekking more time. Getting worse across hospitals and primary care.
4) Older iller people living longer needing more support with no good social service input because I can't see that improving either with families ringing constantly, desperate for help that doctors have no role in providing but "who else is there?"
5) Mental health provision is already woeful. It's getting worse. We're expected to plug that gap somehow but really can't. It's going to be a big big problem going forward.
I could go on but I might have already won the award for the longest ever post.
I would suggest some reading for your daughter , Eccentric. 1) "This is going to Hurt" by Adam Kay - very true to life story of his junior years. Every young doctor I know has read it and says that if you still want to do medicine after that then it's the right job for you. 2) the two books by Henry Marsh - he's a neurosurgeon (and you don't get se.x.ier jobs than that in medicine) "Do No Harm" and "Admissions" (he's a bit of a pretentious tw*t but he writes well and manages to get across some of the changes to the NHS that led him to retire). It would be interesting to see her views after reading those.
Please don't anyone think that I am putting everyone off medicine as a career. For many of us it has served us well and I still enjoy seeing patients most of the time. And I desperately want good young doctors to come through and take some of the empty jobs! But it is definitely not glamorous and getting less so. There is very little respect from patients and that is also getting less so. I had an apparently educated lawyer screaming at me (and I use the word advisedly) for 10 minutes that she would sue me and I would lose everything because I refused to do what she wanted (I was right, she was wrong) - just in the last month.
If your dd goes for it, buy her the "My medical degree is worth more than your Google search" mug as a graduation present - she'll need it :wink:


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PostPosted: Wed Oct 10, 2018 8:38 am 
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Amber wrote:
Ouch.

Over and out then.

I didn’t mean that in an ouch vain Amber. I am sorry it came across like that.


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