Spring is a time of looking forward – associated by me with seeing the crocus and then daffodils as they burst through the winter soil. Hopefully one considers all the potential aspirations that one has for one’s practice, but it is prudent to remember that the professional life has ‘downs’ as well as ‘ups’.
Professional difficulties can take us by surprise in life and may come in many different forms. Relationships with difficult colleagues, loss of business contracts or even bankruptcy, or complaints about the care one has provided (with/without legal implications) can all be demoralising. I have experienced all of the above to some extent, but one occasion remains imprinted in my mind.
The hospital needed to save about £6 million one year and all consultant jobs were reviewed to see where savings could be made. The reviewer was the Medical Director (MD), a retired Dean of a London Medical School who knew nothing about rehabilitation. He asked to see me and stated that he thought I was not doing very much work and so he wanted me to go to the Disability Services Centre (DSC) at the Royal National Orthopaedic Hospital (RNOH) which was run by Northwick Park Hospital where I was based (although about one third of my time involved community-based work). A new consultant post had been created by my colleague Dr Linda Marks in order to support the wheelchair services based there. These included setting up a new service for those needing the newly funded electric powered indoor/outdoor wheelchair service.
This was not easy for me to take in. My work was predominately providing services for those with spinal pain which involved considerable listening associated with advising on all components of disabling spinal pain including the psychological aspects. I had always been happy for occupational therapists to provide appropriate wheelchairs for my patients with severe mobility problems. I really was not technically orientated and certainly not knowledgeable about the technical aspects of service provision. I asked the MD what work he wanted me to give up and he said very sweetly that this was to be in addition to my current workload. I said that I couldn’t do that. He then said that he would get me and my work assessed by two external experts in rehabilitation. I told him he must do whatever he felt he needed to do.
Fortunately, the two consultants who came to assess me were two colleagues that I had contributed to their training in rehabilitation medicine and they clearly understood all the issues involved. I never saw what they wrote about me, but the upshot was that I saw the MD again. He told me that he now understood the nature of my work and that I was fully committed. However, that did not alter the fact that the hospital needed to save money and I would have to go the DSC. That left the issue about which service that I provided at Northwick Park would be axed?
I deliberately nominated the service that I felt would be most likely missed and would thus create the greatest amount of fuss – my community-based work. As the only physician providing support for those with severe disabilities in the community, I thought this would create difficulties which it did. Within three years I was back assisting those individuals but with the help of a team of health professionals which cost very much more than any savings initially created! In addition, we provided a much better service!
Another very positive result of this time was a wonderful letter from one of my colleagues who realised just how difficult that time had been for me and wrote me a lovely letter thanking me for the help I had given her and offering all the support that she could give. Stupidly I disposed of that letter which was a great mistake!
Lesson: Always keep nice letters, ‘thank yous’ etc so that you can refer to them when you get demoralised or fed up.
However, that did not stop me from having to learn all about wheelchairs. My colleague helpfully sent me some articles which suggested that seating was all about the ‘pelvis’! I was not inspired by this and turned up for work with some trepidation.
My morale was greatly improved when I arrived at the DSC for my first day and found an ex-colleague who was a very experienced wheelchair therapist. I confided to her that I felt a bit of a ‘wally’ arriving at the DSC as I had little knowledge about wheelchairs!
‘Oh don’t worry about that’ she said – ‘we know all about wheelchairs – if only you can look after these difficult parents’….. to be concluded next month.
I am happy to discuss any of the issues raised in these reflections with colleagues who can email me at andrew.frank1@REMOVETHISTEXTbtinternet.com and head the email VRA – professional reflections.
Trustee and Past-Chair, VRA