It’s fair to say that our planned webinar, ‘Fit for future practice? Will doctors have a role in the future?’ didn’t go down quite the way it was planned. In this blog I want to address what we were trying to do, and why we are trying to do it. And I’d like, also, to ask a question or two about exactly what the Twitter storm might have taught us – not only at the CFoM, but perhaps more widely too.
First and foremost, it came as a genuine surprise that our title was met with quite so much anger and – frankly – vitriol. That probably marks me out as being a bit naïve, at best – but one thing I don’t accept is that we were malicious in what we were trying to do. We asked this rhetorical question because we are doctors, and because we are feeling the pinch and have the same fears and concerns about the future of medicine as everyone else.
It is, perhaps, a sad reflection on where we now are as a profession that there was clearly a need for us to be more explicit that our question was, indeed, rhetorical. It strikes me as absolutely absurd that any doctor would not want there to be a future for the profession – what we were trying to do is ask exactly what that future does hold – and how might we carve out that future when it feels, rightly or wrongly, that so many forces more widely want to do us down or remove us altogether. We didn’t make that clear enough – and we should have thought that through more. I’m sorry we didn’t.
For the avoidance of doubt and to be absolutely crystal clear, the CFoM is specifically and entirely committed to doctors being doctors, for the long term. That is quite literally what we are about. That’s explicitly found in our reports to date and in our webinars, too. It’s been our starting point from the word go, and it’s because we are committed to doctors being doctors that we want to ask the tricky, future-oriented questions, and ask them in a way whereby we can build up our specific, distinctive professional identity as doctors whilst also getting buy-in from other professions and policy-makers too.
We want to think about this distinctiveness not only in today’s world, but in tomorrow’s, too. We’re doing this in the context of changing populations and the changing planet, in thinking through how we harness and humanise technological advances, and in the training and development of the future doctor. We think these things are of utmost importance – and we believe the thinking needs to be done about them in the context of the next twenty years right about now. You don’t need to take my word for it – our reports show, without question, that this is the case and that this is our mission. It is simply not true to suggest otherwise.
Of course, hindsight is a great thing, and perhaps we should have been wiser about the way we phrased and delivered this webinar, not least given who we had asked to speak in it and the current political climate. It clearly gave the wrong impression about what the webinar was all about. If we did more damage than good on this occasion, I’m deeply sorry and I deeply regret it. We’re not in the business of trying to do doctors down – quite the opposite. I get that people were suspicious and cynical about what we were doing, and I get that we could and should have been clearer about that. But I can also state categorically that we did not mislead anyone involved in these webinars, and I can also say, hand on heart, that if you engage with our previous reports you will find that we share the same frustrations, disappointments, concerns, hopes, and fears, as the rest of the profession. We’re on the same team here.
But I do think these big, existential even, questions are out there – even if we don’t want to recognise that some people are asking them. And I think we need to grab them by the horns, because like it or not, there really are people whose answer to the question ‘will doctors have a distinctive role in the future’ is quite simply not an unqualified ‘yes’. And it matters, because some of those people are making decisions about us, about the future. Putting our fingers in our ears and hoping people will simply recognise what we bring to the table is not an option. As doctors, we are far too often swept up in the wake of the decision making of others – far too often on the back foot. The work we are doing is there to address exactly that issue, and I make no apologies for that. We may have expressed ourselves clumsily in the present moment, but that doesn’t mean we should close our eyes and ignore what’s in front of us instead.
I totally understand that there are many doctors who are really angry at the state of the profession at the moment, and the way they feel treated. I know that, because I’m one of them. I understand, too, that there are many doctors irritated by how we as the CFoM went about promoting this webinar, and I’m sorry for my short-sightedness on how this might be received by some within a profession that is deeply hurting. I’m sorry that we didn’t do it right in the eyes of many social media commentators, and I’m committed – along with the whole team – to listening to how to ask the big questions in a constructive way for doctors, because that’s what this whole enterprise is about.
Which brings me to a reflection on the last few days on social media. I took responsibility for the way our webinar was received because I’m the lead for the group and the buck stops with me. I have no issue with that and I’m willing to own it. But the personal attacks on social media against me, and my character, from senior as well as colleagues at my own stage of training have been mind-blowing. The level of personal vitriol towards me, not least from anonymous accounts, was beyond anything I’ve ever experienced. I’m a core trainee. I don’t work for the whole host of organisations I’ve been accused of working for, I’m not a government stooge or the rest of it. I’m not trying to destroy medicine or sell people down the river. The level of misrepresentation about who and what I am, has been staggering – and it is easy enough to find out what we – as CFoM – and what I believe about medicine and the essential nature of our profession.
It is surely a reflection of how hurt we have been as a profession that we are willing to attack colleagues in this way and immediately assign the worst of intentions, but I just hope we might be able to do better than that. I’m pretty robust, but to be pushed as far as I have been pushed this weekend, psychologically, by anonymous and not-so-anonymous hate online has been beyond anything I ever expected from the people I work alongside, and fight alongside, day by day. Of course I have my faults, like we all do, but the abuse I have faced has at times been close to unbearable – something I have never experienced before.
We’re committed at the CFoM to play our small part in moving the conversation towards a sustainable, distinctive future for doctors. That future is one of collegiality – with others, of course, but first and foremost amongst ourselves, too. That’s what we’re about – that’s what I’m about. And I hope you might enjoy engaging with our work to get there.
Dr Charlie Bell
CFoM Chair of Commission