Sunday 22 June 2014

(Not) Just A Minion

There is a temptation as a junior doctor to refer to oneself as "just a minion". This is particularly true of FY1s/residents, but it persists a fair way up the food chain. After all, we just go around obeying orders and doing as we're told, right? WRONG.

A junior doctor tends to be the first person to be called to a sick patient, whether a new admission or a current inpatient who has deteriorated. Every day we make decisions about whether to start or stop fluids, analgesia, antibiotics etc. We are the ones who decide whether a new admission can wait to be clerked in by us or whether we need to intervene immediately. When we review patients, we are not robots, simply asking a series of questions. We are interpreting (sometimes vast amounts of) information and making complex decisions based on that information. We have spent many years training to become critical thinkers, analysts, problem solvers. It would be utterly ridiculous to then unleash us into a job where we are simply yes-men. Yes, we have limited experience compared to our seniors, but we are still expected to think relatively independently.

A lot of juniors are also under the (false) impression that senior = infallible. This is clearly not true. Sometimes, as juniors, we are the ones who alert the consultants to something important. Prescribing diclofenac as instructed is not a smart move if you recall the past history of gastric ulceration - something a senior may not be aware of (because you took the history, remember?). Your boss may not have seen the latest blood results and it may be up to you to point out the deteriorating renal function or rising inflammatory markers. There are also occasions where your seniors will make errors. Pointing them out doesn't mean being arrogant or argumentative, but a simple "I'm interested, why did you decide X?" or "I was under the impression that you do(not) do that in situation Y" could prevent a patient coming to harm.

One of the main reasons I (and, I suspect, some of my colleagues) dislike the "just a minion" attitudes is that it seems to remove an element of responsibility from the junior, as if their actions and decisions are meaningless. You worked hard at university for a long time. You are paid an enviable salary. You are a member of one of the most trusted professions there is. So stop with the "just a minion" talk. You're a doctor, and what you do matters.

(Thanks to @drbobphillips for suggesting I write this post) 


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  2. Servile and unimportant? I don't think anyone who works in a hospital would welcome that tag.

    1. Of course not - but it's the way lots of people feel from time to time!


And how does that make you feel?