Relieved of the need to think

I was recently at an event planning meeting in which I heard that the local doctors in our town find it very hard to live up to the expectations of the very large Polish population we have. Apparently, "Their expectations are very high," and their confidence in British doctors very low. I was the only non-British person present at the meeting, and it was pointed out with some surprise that Poles know "the names of all the different types of doctors" and expect to be able to access these directly.

It sounded rather as if the Polish medical system was not dissimilar to the one I knew in South Africa. If you have a skin disorder, you make an appointment with a dermatologist. If you're a woman, you make a routine annual visit to your gynaecologist. Until your kids are 12, you are just as likely to take them to the paediatrician as the GP. You know your radiologist from your oncologist, and your ear, nose and throat specialist from your cardiologist.

In the UK, the practice is that you go, in the first instance, to your GP. Always. You will then be referred to a consultant. And that process can take months. Been there. Done that. Nine months for me, last time.

When I expressed surprise that the well-educated, otherwise knowledgeable people present at the meeting didn't know "the names of all the different types of doctors", one person rather proudly pointed out that, with the way the NHS works "we don't have to!"

I had often wondered why all specialists were rather generically referred to as 'consultants', but this explains it. You see a generalist. The generalist refers you to a specialist. The specialist's secretary sends you the details of your appointment. You attend. The specialist reports back to your GP. Your GP reports back to you. You don't ever initiate contact with the specialist. So you don't need to know what sort of specialist s/he is.

I find this approach quite disempowering. I don't feel the need to be looked after in this way. I feel quite capable of identifying the specialist discipline needed in each instance and making an appointment. I feel quite capable of providing said specialist with an accurate history and conducting a conversation about my ailment/condition.

Many Poles obviously experience the same frustration, because they are quite prone to taking their ailments back to (as one Polish woman puts it) "a proper doctor" for a diagnosis that they feel they can trust. This doesn't really help, though, because when they come back from Poland, and feed the information back to the local doctor, the local doctor will not accept histories or diagnoses from abroad, and wants to go back to the start of the process again.

I can think of so many situations in which traditional workplace practices reflect a similar approach. I would far rather see individuals given the freedom to run their own initial diagnostics and then to access to the resources they believe they need in order to get the information/support required, apply it and move on with the day job. Of course they will get it wrong from time to time. That's part of learning, too.

Too much second-guessing can result in a culture where people are waiting to be taken care of, to be told what to do next, have no idea which kind of person/resource holds the solution they need, instead of taking charge of their own lives and figuring out their own 'what nexts'.

Sometimes, taking too much care of people is even worse for them in the long run than taking too little care of them!