Psychiatric Bulletin (2003) 27: 464. doi: 10.1192/pb.27.12.464
© 2003 The Royal College of Psychiatrists
Psychiatric Bulletin (2003) 27: 464
© 2003 The Royal College of Psychiatrists
Less stress or more?
Tim O’Grady
Clinical Tutor for Lincolnshire, Peter Hodgkinson Centre, Lincoln LN2
5UA
Dr Hampson must be congratulated for the very real achievement of
modernising her job plan (Psychiatric Bulletin, August 2003,
27, 309-311). It is surely right to maximise the efficient use of
consultant time by excluding routine tasks that can be safely delegated. I
wonder however if the new job plan might not be even more stressful for the
consultant than before.
My reservation is around the area of ‘supervision’ of other
disciplines and the role of advisor to GPs, a role that involves
‘hearing about patients’ rather than seeing them.
The processes for communicating a clinical problem involve presenting a
short summary of the patient, usually verbally, lasting maybe 5 minutes. It is
similar perhaps to the ‘elevator pitch’ used in the film industry
to outline a movie proposal to a prospective producer.
Listening to the elevator pitch is wearing for the recipient (particularly
if the metaphorical elevator is a slow one or seems to belong to an unusually
tall building). The effect is similar to a PMP exam, where a series of
hypothetical problems is laid before the candidate.
Many of the telephone and verbal vignettes may be risk reduction
transactions rather than genuine requests for advice. As such they are more
likely to be generated by less confident or skilled practitioners, who are
also less likely to be proficient at summarising key points. In the new way of
working the consultant may increasingly serve as a risk depository. Am I alone
in finding delegated working more stressful than direct patient contact?
