What has happened to our doctors?

I recently had an enlightening, and also very disturbing, conversation with retired GP, Dr Philip Bradfield Stowell.

Despite being born into a multigenerational family of doctors, Philip entered medical training in the UK almost entirely unprepared for what the practice of medicine actually entailed. Suffice it to say, he did not care much for the increasingly bureaucratic, algorithmically-driven model of medicine that he encountered both in the UK, and in Australia after he emigrated here.

Dr Stowell drifted into a practice focused on helping patients with complex, chronic health problems… but as he discovered, Australia’s highly-centralised Medicare system judged his patient-centred model of care as aberrant. He was hauled before an investigative tribunal to account for his three sins: spending too much time with his patients, ordering unusual tests, and not prescribing enough drugs. (I kid you not. This is what he was accused of.)

What Dr Stowell witnessed during the COVID episode persuaded him to leave the practice of medicine forever. I’m sure, after listening to this conversation, you’ll agree that his retirement was a sad loss to patients who are desperate to find a skilled doctor who actually cares about diagnosing them accurately and treating them effectively.

Photo by Sasun Bughdaryan on Unsplash

Here are some of the questions and topics we discussed:

• What common misconceptions does the general public hold about doctors, and the practise of medicine?

• How does the selection process for entry into medical school, and the education of doctors (in medical school, during internship/residency, and postgraduate) influence who becomes a doctor, and how doctors practise?

• Was there a ‘golden age’ when medical education and the practise of medicine were any better than today, or have there always been fundamental flaws in the system?

• How does the current system maintain conformity, and what happens to doctors who do not conform?

• If you were granted the magical power to reform medicine, what would you do?

• Realistically, do you think the current system is capable of reform?

• What advice would you give to people with respect to their engagement with the medical system? Should people avoid doctors altogether, or are there any aspects of routine medical care that have value? If someone really needs a doctor, how should they go about finding a good one?

• What advice would you give to young people who are considering a career in medicine?

Finally, I apologise for the audio quality. I was using an external microphone but Dr Stowell was not, so our audio volumes were very different. I’ve done my best to manually edit our respective audio volumes but you may still have to adjust the volume as you listen. Please persist; this is a conversation you will not want to miss.

You can read the transcript if you prefer to read rather than listen, but I really do think you’ll enjoy hearing Dr Stowell’s experiences in his own voice.

I delved into some of what Dr Stowell and I discussed - namely the conflict between the doctor’s duty of care to his or her patient, and the public health directive to treat ‘populations’, in this article:

And the always-on-point Dr Vernon Coleman published this piece, soon after Dr Stowell and spoke, which was highly relevant to our conversation:

A profession which does what it is told to do by an industry is not a profession; it is merely the marketing arm of the industry.

If you have any questions for Dr Stowell, or would just like to send him a message of appreciation,

And finally, if you would like to support my work, I would be grateful if you would consider a paid subscription:

For information on my private practice, please visit Empower Total Health. I am a Certified Lifestyle Medicine Practitioner, with an ND, GDCouns, BHSc(Hons) and Fellowship of the Australasian Society of Lifestyle Medicine.