Doctors need to give up professional protectionism

Clifford Mann is correct in his assessment that new clinicians provide valuable skills and experience in a variety of roles. Whilst he is also right to recognise the benefit of their experience, it is important that this does not come as a detriment to the training of junior doctors.

Assessment, appraisal and reflection may have changed the shape of medical training but junior doctors (as pluripotential clinicians) need to gain experience to guide our differentiation. Systems have not necessarily kept pace with the growth in healthcare professionals and some tasks still require the input of a doctor. Unfortunately, these tasks are often administrative rather than experiential and this encourages employers to keep junior doctors writing discharge summaries, stopping medications and ordering radiographs whilst procedures and clinics are allocated to more experienced allied practitioners.

When junior doctors do have time in these settings clinical pressure may dictate that the practitioner still performs "traditional" tasks because they are more efficient (by virtue of their experience). This places juniors between a rock and a hard place, where consultants bemoan their lack of experience but they are denied opportunities to gain it.

Done well, the use of new healthcare professions will benefit both doctors and patients. In a strained health service, however, where it seems service provision is valued over training one can't help but be a little sceptical.