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Changing world of doctors 2015

“A policeman’s lot is not a happy one.” Gilbert and Sullivan’s well-known conclusion from the Pirates of Penzance clearly applies to physicians as well – globally The reasons are well known. Government, Private hospitals and insurance company edicts on how to treat patients, declining reimbursements, ever increasing costs to run a practice, endless paperwork requirements, constant time pressures and a hostile legal environment all combine to make the modern day physician’s lot a truly unhappy one of operatic proportions.

The impact of declining government-run health care has dis-empowered physicians, leaving them disillusioned.

The past 150 years have been a golden age for doctors. In some ways, their job is much as it has been for millennia: they examine patients, diagnose their ailments and try to make them better. Since the mid-19th century, however, they have enjoyed new eminence. The rise of doctors' associations and medical schools helped separate doctors from quacks.

Licensing and prescribing laws enshrined their status. And as understanding, technology and technique evolved, doctors became more effective, able to diagnose consistently, treat effectively and advise on public-health interventions—such as hygiene and vaccination—that actually worked.

This has brought rewards. In developed countries, excluding America, doctors with no specialty earn about twice the income of the average worker, according to McKinsey, a consultancy. America's specialist doctors earn ten times America's average wage. A medical degree is a universal badge of respectability. Others make a living. Doctors save lives, too. The story is different in developing countries. Doctors are constantly agitating for improved working conditions and pay.

With the 21st century certain to see soaring demand for health care, the doctors' star might seem in the ascendant still.

Other problems have inspired other solutions, with technology filling gaps in the labour force

Technology does not just allow diagnosis at a distance—it allows surgery at a distance, too. In 2001 doctors in New York used robotic instruments under remote control to remove the gall bladder of a brave woman in Strasbourg. Robots allow doctors to be more precise, as well as more omnipresent, making incisions more neatly than human hands can. As yet they are enhancements for surgeons more than they are replacements, but that may change in time. Military drones started off being flown by officers who had gone through the expensive rigours of flight school; these days other ranks with far less exhaustive training can take the controls.

The doctors' power rests on their professional prestige rather than managerial acumen, for which they are neither selected nor trained. But it is a power that they wish to keep. Change is inevitable to fit demands & disruptive technologies.

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