New Ways not Working and the consultoid

There are many concerns about how psychiatrists’ workloads are managed. ^1,2 At times, however, the real issues of underfunding and, in old age psychiatry, increasing pathology in an ageing population, are ignored.

I was recently informed that I need to function as a ‘consultoid’ rather than as a consultant. This sounded rather sci-fi, perhaps like an android or robot, and very surreal. Unfamiliar with the word, I suspected a clever neologism used in a very authoritative way. I checked the online Oxford English Dictionary; it is not there. I thought that perhaps I might try using it when addressing a patient: ‘Good morning Mrs X, I’m Dr Hilton, your consultoid’. But it did not sound right. So I searched the internet; consultoid appears to be an imprecise term including people training to be consultants, ³ general practitioners wanting to keep a hand in hospital work ⁴ and health service developments being made without consultation with clinicians. ⁵ Indeed, far from sci-fi it is quite an old word, dating at least as far back as 1929. ⁴

New Ways of Working with increasing workloads, doctors being removed from the diagnostic, assessment and treatment roles for which they were trained and being ‘consultants to the team’ is perhaps reconstructing a modern, ‘virtual’ mental asylum: relatively few medical staff, risk of inadequate diagnoses, almost all work delegated to lower paid staff and where possible offering social care rather than active medical intervention. Perhaps somewhere, sometime, consultoid work will actually be imposed on us from above. But for the moment, just beware if you are asked to be one. It probably implies lower status, less funding, an android-like telepathic sci-fi diagnostic method and mind-reading relationship with the clinical team, plus a superhuman effort to keep up with the workload.