`Unkind' doctors given bitter pill

Doctors have lost their bedside manner and are unkind and thoughtless in their dealings with patients, an eminent medical professor says today.

Professor Sir David Weatherall, Regius professor of medicine at Oxford University, argues that hospitals and surgeries have become supermarkets staffed by doctors who are no longer equipped with the basic skills to treat patients as human beings.

The impassioned indictment of medical training and the "narrow specialist" it produces is made by Sir David in the British Medical Journal. Sir David, director of the Institute of Molecular Medicine at Oxford University, says "systems of medical care areno longer geared to support very sick people".

Cancer patients are brought close to death by treatment for tumours. "In almost every field of modern high technology patch-up practice, patients are pushed to the extreme of their endurance and not always for reasons that include a careful appraisal of what is meant by the quality of life.

"Above all else, those with distressing chronic or terminal illness need . . . attention and friendship of one doctor whom they can come to trust . Yet this kind of relationship is all too rarely available to them,'' Sir David says. Reductions in junior doctors' hours meant that patients were looked after by a stream of doctors. The same pattern applies in general practice, where the chances of patients seeing their own doctors are equally limited.

Young people who want to become doctors must decide when they are 15 "from which time they are in effect narrow specialists", he says.

"Many come from comfortable middle-class homes, few will ever have been patients themselves and even fewer will have experienced much of the world outside their immediate circle.

"It is not surprising that many of them have difficulties in adapting to the day-to-day needs of patients of diverse backgrounds and emotional requirements and widely different reactions to adversity." Sir David asks: "Have we . . . evolved an education system that from the very beginning is destined to leave many of its products ill-equipped to deal with the multifaceted needs of sick people?"

He calls for a broader-based education for medical students and for governments to accept that doctors need to spend more time with patients.

Sir David also asks qualified doctors how many of them could "put their hands on their hearts and say that they had never been tempted to to avoid spending time with particularly difficult or distressing patients during the last days of a terminal illness?"