Is medicine a dying profession?
Might sound dramatic, but increasingly it feels like the profession of ‘doctoring’ is being slowly diluted in front of us while everyone pretends not to notice.
Am I insane for thinking this way? None of my former medical student peers thought this way and chastised me for thinking this, saying that other staff deserved progression as well and that consultants shouldn’t be exclusively getting paid so much???
The rise of ACPs, ANPs, consultant nurses, PAs and every other alphabet soup role is no longer confined to a few outrageous anecdotes online. This is now standard across huge numbers of NHS trusts. Entire departments are being redesigned around substituting medical labour with non doctor clinician roles.
It’s interesting how the narrative has subtly shifted over the years, a few years ago, the messaging was that these roles were there to “support doctors” and “fill gaps.” Now the messaging is increasingly becoming “Why should doctors have a monopoly over this work?”, “all clinicians can share responsibility”, “doctors who disagree just want to preserve an elitist ideal”, this is becoming more and more mainstream ideas after data proves that doctor replacement isn’t some tinfoil hat conspiracy theory.
Surely the NHS/ the public/ govt/whoever has to realise the reason doctors undergo years of medical school, exams, postgraduate training, portfolio building, audits, research, specialty applications and endless hoop jumping is because the responsibility and complexity of medical decision-making is supposed to require that depth of training? Just because doctors can make mistakes isn’t a justification to dilute standards and let everyone have a crack at it?
I’ve seen trainee ACPs handed rota patterns, autonomy, and departmental seniority that would be unimaginable for actual medical students or FY doctors . Doctors compete nationally for training numbers while trusts bend over backwards to create permanent pseudo-training pathways for non doctor clinicians.
And despite all this “innovation,” NHS productivity still appears abysmal considering the amount of money being poured into the system. Everyone just says keep dumping more money into the NHS to reverse the austerity measure but I’m not sure if that will actually have an impact as it seems trusts seem absolutely incapable of utilising that money efficiently.
What’s really demoralising is that many consultants seem far more enthusiastic about training non-doctor clinicians than actual medical trainees. Junior doctors rotate every few months, get treated as temporary admin burdens, while departments invest heavily into creating permanent ACP led structures.
For context I’m super into EM, and emergency medicine feels like the perfect example of this decline. A&E fought to become a respected medical specialty with genuine expertise in acute medicine and resuscitation. Now many departments feel like glorified triage centres run by a random assortment of clinicians with increasingly blurred roles and little regard for what actual medical practice is supposed to look like.
if the NHS were genuinely serious about solving doctor shortages, they would massively expand and improve doctor training pathways, retain existing doctors, improve working conditions, and increase consultant numbers.
Instead, the system seems increasingly committed to replacing doctors with cheaper alternatives while simultaneously gaslighting doctors into believing it isn’t happening.
How long is this model actually sustainable?
Why is the public so okay for this to happen? At what point did the profession start to decline so heavily, why has it got to this stage, and why does the public hate doctors so much?
Long read sorry