The future is a better place

Christopher WoodhouseIt would be an interesting exercise for each of us to add up the number of occasions on which we have heard the phrase ‘things were better in the past’ or one of its variations. As a follow-up, we could then analyse whether it was actually true.

The article ‘Things ain’t what they used to be – or are they?‘ by Christopher Woodhouse, published in the November/December 2015 issue of Trends in Urology & Men’s Health, points out the obvious conclusion that things could not have been better in the past. As was written 500 years ago: ‘…if the world were always growing worse and if fathers were generally better than their sons, we would long since have become so rotten that no further deterioration would be possible’.

In the case of urology, all aspects have, as far as the patient is concerned, immeasurably improved in the last 40 years and will continue to get better. Many of the things for which the older urologists hanker might have been more exciting for the surgeon but were dreadful for the patients.

Please contribute your views below, but if you want to extol the virtues of urological practice from 40 years ago, you had better have some very good evidence!

Comments (4) Add yours ↓
  1. Jon Rees

    Fascinating article – wholeheartedly agree – I am now old enough to be able to hark back 20 years to my first urology job – sub capsular orchidectomies for prostate cancer, endless injection clinics for men with ED with no other treatment options – even in this short time, massive strides forward!

    December 8, 2015 Reply
  2. Matthew Bultitude

    Indeed – great article. I can think of many examples myself where I think “things aren’t as good as they used to be”. Although of course on reflection most things are better but many of these are related to technological improvements e.g. PACS imaging, better instruments etc. But what about non-technological aspects of the way we work?

    Is the NHS better ? Tricky and topical question although it probably is.
    Is training better ? I suspect not.
    Are pay and pensions better ? No

    But maybe that’s just perception and the next generation will be saying exactly the same thing!

    December 10, 2015 Reply
  3. Christian Brown

    With respect to clinical care our understanding of cancer has changed enormously, we can accurately select patients with low risk prostate cancer and avoid treatment toxicity, we can cure metastatic testis cancer and have modern imaging methods that would seem unimaginable 25 years ago.

    Sadly though the profession has changed and perhaps the good old days may have been better. Less targets, managerial pressures, fear of litigation, with now overwhelming numbers of patients to be seen rapidly with less resources than ever.

    Overall progress and I remain optimistic about the future of urology but being a modern NHS consultant is very different to that of a few generations ago and perhaps not quite as much fun!

    December 11, 2015 Reply
  4. Rick Popert

    There is no doubt that the modern advances in Urological management have had a huge impact upon patient safety and prognosis. The “good old days” is a term that has little to do with clinical urology, we all do the best that we can with what we have and endeavour to optimise outcomes for individual patients.

    The “good old days” in my view refers to a time when perhaps life was simpler. A time with bleeps and pagers and without mobile phones, a time of letters and secretaries rather than emails, hand written medical notes rather than EPR, X-rays rather than PACs, photocopy rather than scanning to a mobile, the Index Medicus rather than the Internet. However although one might hanker for the “good old days”, I very much doubt that we would be able to run a 21st Century service without the innovations to which we are growing accustomed. Tomorrow is now.

    December 30, 2015 Reply

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