Ivory towers

This morning I tweeted about the new report that the BMA Medical Academic Staff Committee have been working on for a while, and is finally published. It’s called “Every doctor a scholar and a scientist” and it does pretty much what it says on the tin. I’m a member of MASC and I was involved in writing it, so I have a vested interested in this, but basically the premise is that EVERY doctor (not just those with an academic contract) should understand the basics of research and education in order to deliver the best quality care to their patients.

It took less than 20 minutes to get a response that included the phrase “ivory towers”.*
What exactly is that supposed to mean? This phrase suggesting the “wilful disconnect from real life” that clinical academics are accused of having is just one example of why ALL healthcare professionals need an understanding of teaching and research. (And I know this document is just about doctors, but that’s because it’s a BMA publication. I think everyone in the team – including the housekeeper on the admissions unit – should be involved).

I think this division between clinician and academic is artificial and it’s dangerous.

There are the obvious arguments about the implementation of research: it’s hard to understand how a clinician would implement the results of a trial or guideline safely without the skills to appraise the evidence for themselves.  If research is going to produce useful and meaningful results, then it needs to be pragmatic.  It seems only fair (in my mind) that a patient who is involved in a research study should have confidence that their entire clinical team has an understanding of research, and how that is regulated and carried out.  Safe & good quality care mean understanding research; and taking responsibility for training and educating ourselves and those around us.

But there is another problem with this idea that “pure clinicians” are somehow more connected with “real life” than those of us involved in research.  It suggests that clinicians don’t have an ivory tower; that, as a Dr, that I somehow understand what real life is like for the patients and their families that I see in my clinical work.

If I’m learning anything from my PhD it’s that I don’t have a clue what somebody else’s life is like; being a Dr puts you in a bubble that is incredibly hard to recognise, and even harder to puncture.

Ultimately, we all live in our ivory towers to some extent.  Maybe we should just recognise that a bit more

*Here’s the thing… I would LOVE an ivory tower, but I’m a researcher and an academic. That means that I don’t get to spend my days hiding away in a lovely library, working my way through my thesis, surrounded by musty books. I occasionally have dreams about days like that; I sometimes run away and hide in the British Library so that I can “treat” myself to this fantasy.

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