Our Trust has asked every doctor in the institution to sign a form stating whether they are working or not on June 21st. They will use this form to dock pay for the ones who intend to take industrial action. The default, if you do not sign the form, is that your pay will be reduced. This has quite understandably p****d a lot of people off. It did me to start with but this course of action WAS agreed with the medical staff committee and on reflection is probably quite sensible. It has been the main topic of conversation between consultants over the past few days and it was during such a conversation on the wisdom of doctors taking industrial action that a hospital colleague asked me a question that got me thinking - why on earth do we need patients to like or love us? These were his arguments to support the notion that we do not - We need car mechanics but they are not bothered whether we love them or not. We hate bankers but whether we like it or not we need the buggers. If patients want good health care, they should just accept the need for relatively well paid doctors and sod them if they don't. This may be an extreme position to take. After all, the need to be polite, truthful and nice to patients is part of being a professional. The need is now enshrined in a constitution that governs doctors and soon 'adherence' to this constitution will be used to determine whether we are fit to practice and be allowed to stay on the register. The gratitude and plaudits expressed by patients is one of the nicest things about being a doctor. It's the least one should expect from patients for whom we sacrifice quite abit of our lives and our mental health - or am I wrong ? This conversation I had with one of my colleagues has made me question this age old assumption . This elevated standing and special relationship we have or should have with our patients used to be a blessing but is fast becoming a curse. It has been codified and used to judge us AND is being used to beat us on the head - doctors are currently seen as amoral and being treated as pariahs for daring to protest about their pensions. Professionalism and the special relationship as we have known it for centuries are being used against us and their existence is being threatened. This is what makes me angry - angry at politicians and regulators for doing it and the BMA for falling into the current trap we currently find ourselves in.