Guest Blog by Kirsty Brightwell written for the Unconventional Careers: Open Community Event on 25th March 2021.

How did I get here?

I didn’t set out to be a doctor, far less a Medical Director. As a student and junior doctor, I variously considered Anaesthetics, Psychiatry, Oncology, Orthopaedics and Emergency Medicine. A career in General Practice was therefore inevitable but it wasn’t enough. I had observed real poverty and racial inequality as a teenager and was brought up with a socialist influence in my family. Whenever opportunities arose I volunteered; in retrospect I craved variety and new experiences but also felt I wasn’t making a difference. The more I learned about my profession and the ways things were, the more frustrated I became. I saw small pockets of funding scattered like crumbs to be scavenged and picked at before being swallowed up by bloated, inefficient systems. I was left questioning my abilities: if only I was better, had more skills.

These attempts to create change were doomed as the status quo was like a force-field: resistance was futile.

I believe I’m a good enough GP and I’m sure some individuals are better off for my efforts. It’s just that the causes of ill-health are not in my gift to fix. I cannot prescribe someone a better life; there is no referral that can undo an Adverse Childhood Event. Following one of my rants, my then Medical Director advised that I could either continue to whinge (I paraphrase) or I could get involved and try to make things better.

It was a lightbulb moment.  Doctors are powerful people but if I was going to make the biggest difference to the biggest number of people the only person I could change was me and I had an opportunity to disrupt the system from the inside.

Doctors are powerful people but if I was going to make the biggest difference to the biggest number of people the only person I could change was me and I had an opportunity to disrupt the system from the inside.

If the definition of insanity is doing the same thing over again and expecting different results then that’s the danger of having leaders from a similar mould. The truth is we cannot afford financially or morally to keep doing things the way we always have. Leadership is important in multiple ways. If we choose leaders who look, sound or act a certain way then we reduce the possibility of colliding perspectives and ideas. There is a risk that people who have similar experiences and backgrounds will have similar ways of thinking. By having a diverse group of people we are more likely to find innovative ways of addressing the wicked problems we face.

Doctors are used to being top of the class and have a competitive drive to stay there. My guess is that for many, like me, this conceals a tendency of low self-worth beyond academic achievement. I am learning to be confident, bolstered as I find others who believe it is our job to keep moving towards better outcomes for all.

Being a leader in the NHS is stressful and demanding; it does not bring more wealth than the day job and status is no more than an attitude but I think I am needed and I know I can make a difference.

Being a leader in the NHS is stressful and demanding; it does not bring more wealth than the day job and status is no more than an attitude but I think I am needed and I know I can make a difference.

The challenge now is to stay true to my values. This is uncomfortable and often feels personally risky. The system will resist and the system is people. That means the pressure to conform is continual. There is a danger that your drive is chipped away and you lose sight of what is important. Every time you question, every time you suggest an alternative view, you may be met with hostility. Sometimes this leaves you questioning your actions and motives. Resilience is required but ideally that is a function of a group.

My advice is find your group. We are herd animals, social beings. None of us do well in isolation. Listen and be curious.

 

Our thanks to Kirsty Brightwell for this guest blog written for the Unconventional Careers: Open Community Event on 25th March 2021.