Abstract
It's obvious why doctors and managers often don't get on – the latter are an unpleasant reminder that healthcare is complex and expensive, that someone has to organize it, and someone has to pay.
Unfortunately, from the moment they thought of going to medical school, doctors have been largely insulated from these harsh realities. A medical degree is generally seen as being far more worthy than shorter, non-vocational degrees, especially those devoted to useless mumbo-jumbo like social sciences and humanities. And, of course, learning to heal the sick is the epitome of righteousness in stark contrast to grubby and morally dubious activities like business studies or accounting.
So doctors start out suffused with a great sense of their own worth and that of their virtually holy profession. The problem is compounded by the NHS being free at the point of care. This is a wonderful thing but unfortunately free at the point of care is all too often confused with free. And this culture is so deep-rooted that virtually every senior medical role model will be frequently heard blaming management for, well, everything really. And, of course, the media fuel the same delusions. In tabloid land, it is always a disgrace when expensive and near-useless treatments are denied, and in the medical press and blogland, the myth that the NHS was fine when doctors used to run it is spouted daily and never questioned. (Note to younger readers – the NHS, in England at least, was rubbish in the 70s and 80s, when we had hardly any managers.)
Doctors are the Wayne Rooneys of the NHS, undoubtedly talented but so protected from reality for so long that we have come to believe in our own myth. When it comes to us, we are the superstars, the team is built around us, and what we do is more important than anything else. We move on a more elevated plane than the rest of the world, and please don't suggest that something as trivial and tarnished as money should limit our ambitions. A manager's job is to point out these harsh realities, which of course inevitably leads to superstar sulks and the rest.
So, no solutions, but you can't start treatment without a diagnosis.
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