Dr Dean Eggitt
GP | Teacher | Politician | Speaker
- January 24, 2026
- 10:55 am
- 10 Comments
🩺 Clinical Reflection Case: The Discharge Dilemma
You’re a junior doctor on the acute medical unit. It’s Friday afternoon, and the ward round is moving slowly. The team is stretched – beds are full, the emergency department is backed up, and the pressure to discharge patients is mounting.
Mr. Patel, a 76-year-old man with heart failure, has improved clinically. His observations are stable, and his diuretics have worked. The consultant suggests he could go home today. But you pause.
You remember his daughter mentioning that his home support was withdrawn last month. He lives alone. His mobility is poor. He’s confused at times. You check the notes – no social work referral has been made.
You raise your concern. The consultant hesitates, then agrees to delay discharge until Monday. You make the referral and speak to the ward manager. Later, you overhear the bed manager questioning the decision: “We need that bed. Why is he still here?”
You feel the tension. You’re junior. You don’t set policy. But your voice changed the outcome for one patient – and triggered a conversation about discharge safety.
That evening, you attend a teaching session on integrated care. The speaker, a GP involved in local commissioning, describes how clinicians shape pathways, influence funding decisions, and advocate for system change. You realise that the decisions made at the bedside ripple outward – into policy, into planning, into the future of care.
You begin to wonder:
What does it mean to be a doctor who not only treats patients, but helps shape the system they move through?
How do individual doctors negotiate with colleagues, challenge assumptions, and influence change – even when they’re not in positions of formal power?
The privilege of being a doctor extends far beyond helping the patient in front of you. Doctors are involved in the creation of pathways of care and government policies. How do you think individual doctors negotiate and influence others?
I think that even small acts, such as raising a concern to a colleague, can make a big impact on the rest of the system as long as other people listen. You need to take action on the decisions you make.
Doctors raise awareness to issues only they can experience when being near patients these are made aware of in board meetings and if enough people raise this it can ignite change within the community and government which will hopefully be considered and made into a helpful policy.
advocating for the correct treatment you believe is necessary is more important than pleasing your colleagues, even though it is awkward and uncomfortable.
Doctors’ negotiations with colleagues can occur in both formal and informal settings (either in official meetings / reports or in simple conversations as in the example) and both of these can occur even when not in official policy-changing roles. These everyday discussions are the main way I believe that doctors are able to negotiate and influence others – through the open exchange of knowledge and experience in order to optimise patient care.
Individual doctors negotiate and influence others by coming up with ideas that benefits most; an idea that would be hard to argue/be against. They might also work alongside a team in their department to come up with a plant.
Doctors constantly receive first hand views and opinions from the public and how they perceive hospitals and the medical profession in general. This helps to shape how institutes like the NHS work as doctors will voice the concerns and issues not only from their patients but their own on how it should be ran in a way that will be beneficial to both the patient and doctors who work in hospitals and GPs.
It is very important to take everyone’s opinions and thoughts into account as these will broaden your understanding. Individual doctors can negotiate and influence others by listening to different perspectives and, when disagreements occur, responding in a calm and balanced manner.
I think that doctors negotiate and influence others from experience they’ve had with patients and argue what would be most beneficial to them and their needs.
Doctors negotiate and influence others through open discussion and communication with both each other and patients. Through this, valuable experience can be shared throughout the medical community and hopefully have a positive impact on legislation.
I think doctors are able to advocate for important issues as they hold responsibility to manage their environment and negotiate in order to raise awareness.