‘Doctors & Managers. We’re on the Same Side. Right?’

You forgot we’re a Team.

So recently I was part of a NHS Change Model Twitter Discussion between managers, consultants, some doctors and some patient group representatives. About a third of the way through a patient group representative made a statement along the lines of, “Aren’t we all on the same side?”.

It got me thinking.

Are we really?

I mean in a perfect world we’re all their to treat the sick and to relieve the pain of those who sadly can’t be treated anymore. Everything from budgets, to equipment procurement, leadership and clinical practice is supposedly there to treat patients and improve peoples’ health.

But is that how we really think about things? Let’s take a closer look.

‘I want to be a Doctor so I can help People!’

Oh really? Did you consider social work or charity work in that case?

I kid, I kid! A little…

You see doctors and nurses treat people on a daily basis so it becomes second nature and because we’re just humans other factors start to take precedent. Whether it’s overly complex and bureaucratic training systems, the hunt for jobs or the never-ending chain of exams and assessments somewhere along the line everyone gets a little jaded.

With the weight of the world they’re carrying on their shoulders from house officer to consultant it can become and endless struggle even for the most optimistic. It’s there and politics doesn’t make it any easier because we all have mortgages and bills to think about.

BUT. Above all, we all care about our patients and many doctors know what will make a difference but suggestions from the frontline often fall upon deaf ears so much so that they succumb to the world of procrastination because…

‘We’ve got to balance the books!’

‘Money, money, money. That’s right, I’m a manager and I need to balance the budget. I need to generate income and cut costs any way I can.’

I exaggerate. Slightly.

Doctors often complain that’s all managers care about and nothing else. Here’s the thing guys we can’t have hospitals without money.

That’s the world we live in and somehow we need to get around often enormous costs to even get by on a daily basis let alone forecast the future. We’re happy to give managers that burden and expect them, often with no experience of healthcare, to be able to balance the books whilst thinking directly about life on the frontline.

Even patient care has become a set of statistics and numbers because of never ending government targets. Not meeting targets? Get fined! More numbers! No wonder none of them have any time to even consider taking the time to learn about the stresses and strains frontline healthcare staff go through on a regular basis.

And where do all these good natured targets come from?

‘Vote for Us and We’ll put the NHS first!’

Promises. Party politics. Oh they’d promise us the world to get into Westminster, the White House or wherever else.

It’s an unenviable task to balance the ultimate national budget and often the decisions come from people who have never spent a day in hospital beyond the occasional visit to declare a new facility open. Even if you spend days shadowing doctors unless you do the night shifts and  the on-calls with dwindling resources or staff then you don’t really get a flavour of the harsh realities of healthcare.

If you haven’t been at least a manager in a hospital and tried to negotiate and compromise with doctors and nurses then you’ll never understand the dynamics at play.

But you’re calling the shots. You can invest in think-tanks and what not but unless they’re engaging immensely closely with doctors, nurses and managers and listening to patients then it all won’t mean anything.

The biggest problem is that whenever anyone tries anything meaningful by the time they get anything from paper to reality they’re out of power and everything gets repealed by the new government or administration and we’re back to the drawing board.

So What do we Do?

Sure, we have to talk. We have to listen.

It’s not enough. We have to experience. We have to develop insight.

Doctors need to spend time observing what managers do and we need to develop a training program for junior doctors with an active interest in management.

Managers need to experience what it’s like to be working as a doctor or nurse in the middle of the night or on call. The trials and tribulations of accessing patient records, getting equipment and handling emergencies and failing computer systems.

Just a little insight could take us all a step forward. On the same side. Caring for our patients the best way we each know how.


Dr Saif Abed
Founding Partner
AbedGraham Healthcare Strategies Ltd



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