Liam Farrell: There are no real winners in the race for points

Put the tag on its toe and gratefully slam the door;

The annual points race is dead and gone, the annual frenzy which is incapable of appreciating the crucial distinction between collecting useless information and acquiring vital knowledge, which puts a value on things simply because they can be measured rather than because of any inherent importance they might possess.

The indignity of the points race also degrades the doctor-patient relationship. Our patients depend on us to act solely in their best interest, and always seem rather surprised and disconcerted when we interrupt the consultation by holding them upside down by the ankles and shaking them hard to see what points might fall out. We behave this way because now we have our own interests to consider, and self-interest can be an unconquerable compulsion.

Aristotle and Spinoza (for some reason they aren't on the medical school curriculum, possibly because medical students aren't really all that bright, but then neither are their professors) believed that all behaviour is determined by enlightened self-interest and that all desires are self-referential; my experiences have taught me that they were spot on (those Greeks, weren't they something? Those parties in The Groves of Academe were legendary).

Our self-interest, our desperate search for points, has turned us from discriminating professionals into ciphers without any degree of discretion as to what is and what is not relevant.

For one small but annoying example, every patient with depression, no matter how mild, has to be taken to our own little Ministry of Light (The Place Where There Is No Darkness) and be interrogated in Room 101 by the dreaded PHQ9.

'Do you fidget (a) not at all, (b) some days, (c) most days, or (d) every day?' I asked, squirming at the stupidity of it all.

'Fidgeting? What are you asking me about fidgeting for? What has that got to do anything? What am I doing here anyway? I come in because I'm feeling a bit down and looking for some help; you're the one who is fidgeting,' accused Joe, and I realised I had been scratching my left ear with my right big toe in sheer embarrassment.

'OK, Joe,' I said, 'at a wild guess, that means not at all.'

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