Monday, 21 July 2014

Quitting a Profession: Higher Education, Law, Medicine

As the prologue of Infernal Coalition (above) shows, law professor Susie Harris found herself contemplating a career in Conservative politics, thanks to the party leader’s apparently sincere call for more ordinary people untainted by past political involvement to come forward as candidates. It would have involved walking away from academia and taking a leap into the unknown, all for the purpose of becoming involved in something new and different, and promoting the higher goal that had been proclaimed in the first place. (With the real life Infernal Coalition now over 4 years old, we may recall that proclamation and weep, but that’s another story…)

It is easily forgotten that qualifying into and practising in a profession is something distinct from a mere job or career. Professionals spend many years obtaining their unique qualifications, sacrificing potential short term gain in doing so. Upon admission into their professional body they will be expected to put others’ best interests first, even if those interests may conflict with their own. A good lawyer will recommend acceptance of a sensible deal, and deter pursuit of a futile claim, even if it means losing out on fees. A good doctor will similarly resist the temptation to sign a malingerer off work, or to prescribe unnecessary medicine or treatment when the solution is perfectly within the patient’s capability and willpower, resisting the “anything for a quiet life” mantra. And a good teacher will mark incorrect work wrong, and withhold a pass grade from a fail paper, even if targets fall by the wayside and malcontents complain.

And after so many years of keeping to professional principles, how far are they carried over and sensibly applied when an even higher calling beckons? Well, for a lawyer seeking to become a judge, it ought not to be too difficult – assess all the evidence and then decide, rather than simply advise and act. And for a professor seeking to become a politician, there’s every chance for logic, reason and academic freedom to find their practical use in the running of a country, especially when combined with many years’ worth of knowledge of the national education system and how, unknown to the average non-specialist politician, it might be failing. (Yes, of course there’s also every chance for new MPs to abandon their principles, go native and stick their snouts in the trough, but there are many honourable exceptions…)

Which leads me to the medical profession. Consistent with the “we must be seen to be doing something” doctrine that seems to be a key principle of NHS administration, perhaps combined with “especially if it enables the creation of more fake work and more highly paid managers’ roles”, they have in recent years introduced “revalidation” for GPs. The supposed idea, to make them demonstrate that they are up to date and fit to practice. Never mind professional pride and common sense. Ignore existing workloads and work-life balance. Take no notice of the fact that the existence of the occasional bad apple will not mean that every GP must be tarred with the same brush. Just assume Guilty Until Proven Innocent, and devise a time consuming and burdensome system that leaves them having to demonstrate training course attendance and to ask patients and colleagues for testimonials. Is this really the way to treat professionals, and is it really likely to make any NHS stakeholder (excuse the Blairism) feel any better about it? Hardly.

And how does quitting professions come in? No, it’s not simply the wave of early retirements of competent but exasperated GPs in the face of the ever increasing bureaucracy, which may one day sink in with the NHS top brass as a practical illustration of the law of unintended consequences. It’s the curious fact that the full time GP assessors evidently include former practitioners who have chosen a career in regulation in place of one in medicine. And who have adapted to their new role by communicating with their perfectly capable and competent former colleagues about the jumping of hoops and the meeting of deadlines in tones more suited to clipboard wielding local government jobsworths rejoicing in their ability to tell small businesses all about their powers to close them down.

There are clearly meritorious reasons to quit a profession. But do they really include the pursuit of a career like this?

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