Is the Royal College of Physicians really a trade union?

The Royal College of Physicians has published its census results.  And it makes intriguing reading.  But for the full extent of intrigue you have to read between the lines, as well as the lines itself.

It is interesting that the press release makes for really morbid reading.  There is not one bit of good news in it.

I was close to topping myself, and going and buying all my consultants a round of baby-cham (not in that order, you understand, as that would be ridiculous).  But before I did so (either of those things, in the appropriate order), I thought I would actually read the report, and come to my own conclusion.

Here are the three things that struck me:

1. The feminisation of medicine is striking (chart C13b on page 27)
2. Clinicians do not feel that the overall quality of care has changed much over the last 3 years (chart 32d on page 65)
3. Clinicians enjoy their job - over 80% of them enjoy their job always or often (chart 33a on page 66)

Now, you would not have found any of those messages in the press release - which was all about gloom, and more gloom.

Why is that?

The only conclusion I can come to is that the RCP is trying to make a political point.  As justification, your honour, I pray leave to submit the following exhibits as evidence:

• The focus on the NHS.  Why would this not be a general survey of how all their members work across potential employers - including NHS, private hospital groups, academic institutions, other commercial institutions.  This is not so much a census of consultants and registrars, as much as it is a data gathering exercise on the experience of members with one particular employer.
• Within the NHS focus, focus on the contracted vs actual hours worked.  I am intrigued that BUPA insurance has kept its private reimbursement limits for consultants fixed for a substantial length of time.  But this gets at nothing like that - all about the NHS and programmed activities.  I spend my life telling managers not to focus on PAs.  Doctors are professionals, and they focus on patients - not on filling a hourly timesheet according to their PAs.  But the RCP seems to be wanting to focus on this.
• Question choice.  So everybody knows that by introducing EWTD one would have expected continuity and training to suffer - that is the logic.  The reason you would do it is because doctors are more alert and fresher to do care for patients when they are actually working.  But it is training and continuity that the survey focuses on (charts C28a, b and c); not on the alertness etc.  And indeed, if one wanted to get to the bottom of this issue, one would also come at it differently - what are the total hours worked by consultants including their other commitments (private, academic, etc).  It is only by looking at this that you can fully evaluate the ETWD.
• Reporting style.  I have also shown the negativeness of the reporting.  But on each question, the glass is always half empty.  For example, in the real world the compliance of a policy with law is always greater than the compliance of working practice with policy.  Only in the perfect world is this not true.  So to report that "29.6% of departments do not work EWTD compliant rotas in practice – despite 94.7% being compliant on paper" without context or comparison is to scare the horses.

So, my advice to consultants is to cancel either your BMA or Royal College subscriptions - as they effectively seem to be doing the same thing.