New Ways of Working and the patient

Dr Gee is certainly not the only psychiatrist with misgivings about the New Ways of Working for consultant psychiatrists (Psychiatric Bulletin, August 2007, 31, ). I share his concerns both in my capacity as a consultant psychiatrist with 20 years’ experience and as an NHS patient for the past 4 years. In the unequal relationship of the doctor and patient, an essential element of the healing process is faith in the doctor. The patient wants the doctor to take charge and guide them through the illness. Seeing my consultant physician continuously through thick and thin over 4 years has been extremely helpful. I cannot say the same about my care under other hospital departments where doctors change in a bewildering fragmentation of rotas and sub-specialties.

Psychiatry is now adopting the worst aspects of acute hospital medicine. A patient familiar with a consultant psychiatrist is now handed over to a group of strangers in a crisis team as soon as the going gets tough. Consultant psychiatrists are expected to no longer ‘waste’ their time seeing patients over extended periods in out-patient clinics. However, I have often been surprised by the gratitude of patients for what seems so little effort, namely simply being there for them. The tradition of doctoring is being abandoned for a role akin to a medicines technician. In this era of user empowerment did anyone ask the patients what they thought about this New Way of Working?