A Doctor is one of the closest things to a King or Queen we encounter in UK public services. How much power do you think they actually have?
Join the discussion on LinkedIn: https://www.linkedin.com/posts/antlerboy_publicservices-activity-7158014653145497600-hPhg?utm_source=share&utm_medium=member_desktop What do you think are the implications for #publicservices?
To see my doctor, I have to petition him – find a way to reach his courtiers.
If my case is good enough, I’m given a time at his discretion, in his visiting hours.
I present myself to his guards, with my proper papers.
I must be on time, or I forfeit my opportunity!
I attend upon his pleasure in ‘the waiting room’.
At a certain point – perhaps on time, perhaps late – my name is called, and I proceed to his antechamber, knock, and am granted entry.
I sit on the humble chair before his throne of power – he consults the oracle of all worldly things (the computer).
and I can petition him with my woes.
Can you think of a modern ritual so perfectly set up to mimic seeking an audience with the King – or at least, a local Duke or something?
Most of the time, modern medicine being what it is, I’m given a prescription – medicine that will hopefully alleviate my symptoms, or even make me well again.
So, with all of this symbolism and power and pomp, when I am given the medication, the thing that will save me… what proportion of prescriptions handed out do you think are filled at the pharmacy, taken, taken properly with attention to the instructions, and taken to their full course?
What do you think are the implications for #publicservices?
chosen path 
I should have realised how this would be taken as a complaint against doctors (it’s not really!) and how it was focused.
However, my intended point is to emphasise the power and symbolism of the doctor-patient relationship and the act of ‘giving the prescription’ – truly the cloak of the expert doesn’t get bigger and more impressive!
Perhaps the symbolism fo the ‘giving’ is almost *too* strong – and in some cases replaces the actual taking of the medicine and the self-care needed in the Poor Sick Miserable Person’s mind?
In any case – if we think we have power in public services – look at this:
Combining studied attrition rates for medical adherence in a hypothetical model, starting with 100 prescriptions:
– 20-30 are never filled (say 75 left)
– Of the 70-80 filled, 7-16 are not taken at all. (say 63 left)
– Of the 54-73 who do take the medication, 27-37 are taking it incorrectly. (say 31 left)
– Of those, 13-19 do not complete the full course.
So perhaps 15% of patients follow this grand God-like authority to the full!
[NB based on cited, published papers but NOT good science, indicative]
We in public services *never* have the power per se – it’s people in their (our) lives who have to make the difference.
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