Since 2012 all doctors practicing in the UK are required to undergo revalidation every 5 years.
I have been preparing all that it is necessary for my forthcoming revalidation interview. As part of this process I am required to gather multi-source feedback (MSF). Like my previous revalidation in 2013, I have received overwhelmingly positive feedback. However, I am always keen to learn how to improve in my professional role as a doctor, and so, in this post I wish to consider a comment that stood apart in my MSF report [MSF comments are all anonymous]. I will also consider whether MSF feedback may have the potential to reinforce establishment and professional outlooks and approaches.
The comment that stood out in my MSF report was included in the section “Working as a Team” and it stated [Dr Gordon] “needs to be less vociferous about his pet projects”.
The dictionary definition of ‘vociferous’ is:
A generally accepted definition of a ‘pet project’ is:
As an anonymous comment, all that I can say about its source is that it was from a fellow healthcare worker who practices with me in psychiatry. One of the aims of MSF is to allow doctors to have sight of themselves from the vantage of others. This is insight we should all be open to whether the comments are positive, negative or in between. However, as a most reflective practitioner I find that the lack of context to anonymous comments like this makes it difficult to consider them properly. Doctors, like all healthcare professionals, work in complex systems where it is increasingly understood that candour, questioning and openness are important to improvement of organisational approaches to, and reflection upon, the care of those we have professional responsibility for.
The MSF comment that I need to be “less vociferous” about my “pet projects” has indeed left me reflective. What does the commentator consider are these “pet projects” and in what way am I “vociferous”? In what follows I can only speculate.
“Pet projects” might include my interest in what the following can add to improving healthcare:
- listening to the evidence of experience (lived experience)
- that evidence informed medicine also requires philosophical considerations
- that words and numbers matter equally, but both represent ‘losses’ in terms of actual experience
- that ethics should underpin all that we do
- that transparency of competing interests is essential to science
- that over-medicalisation is a matter that we need to consider seriously
- that the idea of ‘two cultures’, science and arts, is an artificial divide that should be challenged
- that subjectivity needs to be reintegrated into science
- that wider reading and exploration of the world round about us, adds, rather than detracts from being a skilled and caring professional
- that the history of medicine reminds us that critical thinking is necessary to establishment practice
- that good intentions are not sufficient. Professionals are just as vulnerable to exhibiting stigma as any other person
“Vociferous” might mean (as I do not shout or speak loudly and am actually timid: people say I am “brave” but this is not what I feel):
- that I am passionate (I agree, and I am proud to be so)
- that I do not act my role as a doctor (it is more than a profession to me)
- that I am not part of the “herd” (generally, it seems we all naturally feel safer in the herd)
- that whilst I find it challenging I am willing to voice uncertainties which can cause discomfort
- that I will not take for granted the establishment view unless I am convinced that the potential benefits outweigh the potential harms of any intervention.
I will continue to reflect on this comment and what it might mean for myself. I will also continue to reflect what such a comment might mean at an organisational or system level and whether it indicates anything about the profession of which I am part, that being psychiatry.