Skip to main content

Main menu

  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us

Clinical Medicine Journal

  • ClinMed Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About ClinMed
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

User menu

  • Log in

Search

  • Advanced search
RCP Journals
Home
  • Log in
  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us
Advanced

Clinical Medicine Journal

clinmedicine Logo
  • ClinMed Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About ClinMed
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

The role of the future physician: building on shifting sands

Linford Fernandes, Michael EB FitzPatrick and Matthew Roycroft
Download PDF
DOI: https://doi.org/10.7861/clinmed.2020-0030
Clin Med May 2020
Linford Fernandes
ALeeds Teaching Hospitals NHS Trust
Roles: neurology clinical research fellow
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: matthew.roycroft@nhs.net
Michael EB FitzPatrick
BUniversity of Oxford
Roles: gastroenterology clinical research fellow
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Matthew Roycroft
CSheffield Teaching Hospitals NHS Foundation Trust. All authors contributed equally to the manuscript.
Roles: ST7 geriatric medicine
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
Loading

Article Figures & Data

Figures

  • Tables
  • Fig 1.
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig 1.

    Key themes facing the physician today which will impact on their future role.

Tables

  • Figures
    • View popup
    Box 1.

    A day in the life of a consultant gastroenterologist in 2040

    8.00am Handover from the Hospital at Night team
    All patients requiring urgent gastroenterology review are automatically flagged by the electronic patient record (EPR) system. We discharge Philip, a man admitted yesterday for a gastrointestinal bleed. The EPR auto-generates the discharge medication and a discharge letter using natural language processing of the clinical records, which we review and edit in real time. He starts packing immediately – the discharge summary will be with him and his GP by email instantly, and the medication will be delivered to his home that afternoon.
    8.30am Multidisciplinary team meeting to discuss inpatients
    9.00am Inpatient ward round
    Ward round maps plot the most efficient route to the patients, factoring in physiological derangement and potential discharges. The integrated analytics system in the EPR picks up trends in blood tests, flagging concerning trends and suggesting additional tests and interventions based on Trust policies. The EPR is linked to guidelines and evidence, and pulls through key links in real time, augmenting decision-making and learning on the round.
    12.00pm Virtual ward review and urgent virtual clinic
    Many patients are managed via the hospital at home set-up and we review them with the community physician associate and nurse via teleconference, with live physiological parameters from the patient from point-of-care sensors linked to the EPR via the internet. One patient requires specialist renal input – we arrange a video consultation with us, the patient and the specialist.
    1.00pm Lunch
    1.30pm Administration
    I catch up with my paperwork – there isn't much to do. Referrals are processed by the EPR artificial intelligence system, which then suggests appropriate clinics and investigations for the patients for me to approve. Lab and endoscopy results are also processed by the EPR AI, with letters to patients and GPs created based on my previous correspondence, which I edit as required.
    2.00pm Endoscopy list
    This is a blended endoscopy session. First, I review the AI interpretation of the upper GI and colonoscopy capsules performed yesterday and approve reports for dispatch. There are two clinical and nurse endoscopist lists in parallel with my therapeutic procedure list. Real-time image analysis performs enhanced polyp detection and allows automatic interpretation of pit pattern and morphology to decide whether resection is necessary, assisted by endoscopic robotics for larger high-risk polyps. Endoscopy reports are generated automatically based on the findings.
    4.45pm Acute Medical Unit handover
    5.00pm Review of patients from the acute medical floor
    Physician associates and advanced care practitioners work alongside medical trainees assessing patients. The hospital's electronic communication system allows for online specialty advice and input, facilitating patient flow through the unit.
    8.00pm Handover to the Hospital at Night team
    Having done 12 hours work, I hand over to the off-site consultant covering the night. It's recognised my decision-making after 12 hours isn't optimal and being woken at night impacts my performance the next day (when I'm only in for a morning ward round).
Back to top
Previous articleNext article

Article Tools

Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
The role of the future physician: building on shifting sands
Linford Fernandes, Michael EB FitzPatrick, Matthew Roycroft
Clinical Medicine May 2020, 20 (3) 285-289; DOI: 10.7861/clinmed.2020-0030

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
The role of the future physician: building on shifting sands
Linford Fernandes, Michael EB FitzPatrick, Matthew Roycroft
Clinical Medicine May 2020, 20 (3) 285-289; DOI: 10.7861/clinmed.2020-0030
del.icio.us logo Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • ABSTRACT
    • Introduction
    • The future workforce: blended, multiprofessional and flexible
    • The future patient: an equal partner in the management of complexity
    • The future healthcare organisation: from cure to prevention via integration
    • The future of health technology: restoring the humanity to medicine?
    • Training the future physician
    • The future in light of the SARS-CoV-2 pandemic
    • Conclusion
    • References
  • Figures & Data
  • Info & Metrics

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Principles and practice of deploying a flexible physician workforce for COVID-19 care wards from a Dutch hospital
  • COVID-19: the physician's response in the first phase
  • Google Scholar

More in this TOC Section

  • Real-world use of the Breathing Pattern Assessment Tool in assessment of breathlessness post-COVID-19
  • Understanding the diagnosis and management of multisystem inflammatory syndrome in adults (MIS-A) in the UK: results of a national Delphi process
  • The clinical course of pneumomediastinum in patients with SARS-CoV-2 before invasive mechanical ventilation
Show more COVID-19 rapid report

Similar Articles

FAQs

  • Difficulty logging in.

There is currently no login required to access the journals. Please go to the home page and simply click on the edition that you wish to read. If you are still unable to access the content you require, please let us know through the 'Contact us' page.

  • Can't find the CME questionnaire.

The read-only self-assessment questionnaire (SAQ) can be found after the CME section in each edition of Clinical Medicine. RCP members and fellows (using their login details for the main RCP website) are able to access the full SAQ with answers and are awarded 2 CPD points upon successful (8/10) completion from:  https://cme.rcplondon.ac.uk

Navigate this Journal

  • Journal Home
  • Current Issue
  • Ahead of Print
  • Archive

Related Links

  • ClinMed - Home
  • FHJ - Home
clinmedicine Footer Logo
  • Home
  • Journals
  • Contact us
  • Advertise
HighWire Press, Inc.

Follow Us:

  • Follow HighWire Origins on Twitter
  • Visit HighWire Origins on Facebook

Copyright © 2021 by the Royal College of Physicians