Doctors Now and Then
Dr Vernon Coleman
Doctors are, it seems, unhappy with their lot.
Junior hospital doctors (they now want to call themselves something else but that is what they are) are threatening to go on strike again if they don’t receive a massive, third inflation busting pay rise. Thanks to EU employment legislation, today’s junior hospital doctors work an average of a 40 hour week. If they do any work at night or weekends it must count as part of their 40 hours. The result that it is common for hospitals to have no doctor available at nights or at weekends. And junior doctors, still in training towards a post as a consultant, can earn £60,000 or more.
I’m not sure whether or not GPs are actually on strike (they do so little work that it is difficult for anyone to know) but they’re constantly grumbling about their workload. For the record they work an average of 23 hours a week and earn the best part of £150,000 a year for this – plus another £50,000 a year to tell a staff member to vaccinate every patient who is innocent enough to agree to be vaccinated. Many GPs now refuse to see patients at all – insisting on doing all their consultations on the telephone or via the internet, even though this sloppy type of medicine is disastrous and results in misdiagnoses and inappropriate treatments.
I’m tired of all the moaning from miserable doctors.
Here’s how things used to be.
When I was a junior hospital doctor I worked a minimum of 84 hours a week. We were the lowest paid people in the hospital. Two of us were responsible for a couple of wards full of patients. When one of us was ill or on a holiday the other worked for 168 hours a week. It got a little tiring towards the end of the week but we managed. I don’t remember any of my colleagues ever complaining. We all slept in the hospital (in rooms just big enough for a bed and a chair) and shared a bathroom. We ate in a canteen. (The cost of our room and food was deducted from our pitiful pay.) We were available for our patients whenever they needed us. When we were working a 168 hour week we couldn’t leave the hospital grounds but we had little beepers in our pockets and could be found at any time of day or night. At times when I wasn’t on duty I would sometimes be conscripted to work in the hospital casualty department. We were paid an extra couple of quid for this.
No one was ever made ill by this workload. We learned a great deal.
When I was a GP the routine was simple. I did a surgery in the mornings and saw about 20 to 30 patients. (Curiously, there were usually fewer patients on a nice sunny day.) After the surgery I made phone calls, read the mail, dictated letters, signed letters, signed prescriptions and met the district nurse if she was around. We took our blood samples, stitched wounds, removed stitches, syringed ears and took swabs. We did all these things ourselves and thought of them as an essential part of a GP’s job. (Modern GPs often send patients to hospital to have these things done. Probably because it is difficult to syringe an ear when you’re working from home – misdiagnosing patients by telephone.) When I’d finished in the surgery, I visited patients who wanted to be seen at home. After lunch I visited a few more patients and read the medical journals to keep up. At 4 pm I began the evening surgery which usually finished at about 6.30 pm or 7.00 pm. Every GP I knew worked in much the same way.
There were five partners in the practice where I worked so I was on call one night a week and one weekend in five. We took it turns to be on call on bank holidays such as Christmas. There were far fewer doctors per 100,000 patients then than there are now and we had far more patients to look after. We had around 2,500 patients each whereas modern GPs often complain if their lists are over 1,000 patients per doctor.
When I was on call the phones were switched through to my home telephone number after I finished my evening surgery. And the following morning, when the receptionists arrived at the surgery, the phones were switched back. Some nights there would only be one or two calls but on other nights I would hardly get to bed at all. Naturally, I would work a full day after being on call for the night. So, once a week we’d be on duty for a continuous 36 hours .
Weekends did sometimes get a little tiring but I honestly don’t remember anyone complaining. I’d work the Friday as usual and then at the end of the evening surgery the phones would be switched through to my home. I’d then deal with all the phone calls and queries and emergencies until Monday morning when the phones would be switched through to the surgery. I’d then do the Monday surgeries and calls as usual. It was vital to fill the car with petrol on a Friday before a weekend on call because running out of petrol at 3.30 am on Sunday wasn’t a good idea. There weren’t any mobile phones then so sometimes I’d drive a few miles, see a patient, drive home and then have a message to go out to another patient a few doors away from the first one.
So, if it was a busy weekend I’d have worked constantly from early Friday morning until the end of the evening surgery on Monday when I could put my feet up or go to sleep. So a weekend on duty would mean working for 82 hours continuously. Single handed doctors (and there were still a few would be available for 168 hours a week – only taking holidays when they could find a locum.
It wasn’t particularly arduous. And I still had time to write a few books and mow the lawn.
Today, most GPs never visit patients at home and are never on call at nights or at weekends. The result is that neither the ambulance service nor hospitals can cope. And patient care is frequently worse than appalling.
I’m not saying doctors today should work as hard as we did. And I’m certainly not complaining about how hard doctors used to work. I’m just saying that doctors should stop whingeing and complaining of being overworked and underpaid when they are patently neither overworked nor underpaid.
So, why do today’s doctors appear to be so damned lazy? Why don’t they care about their patients? Why don’t they have a sense of vocation or responsibility?
That’s a another story and quite a complicated one… if you really want to know why medical care has deteriorated so much you can found out in my book `The End of Medicine’. (CLICK HERE if you’d like to purchase a copy.)
It breaks my heart to see what has happened to medicine. It really does.
NB My series of 16 books about a Young Country Doctor describe a doctor’s life in the 1970s – a time when life was rather different in every conceivable way. To purchase the first in the series please CLICK HERE
Copyright Vernon Coleman June 2025
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