A physician’s worth doesn’t need a professional hierarchy

by Ruben J. Rucoba, MD

Has it come to this?  Do we really need, as a profession, to measure ourselves against others like a bunch of schoolboys?  After reading Dr. Son’s article, “Does being a lawyer or journalist stack up with being a physician?”, I feel compelled to reply.

As a practicing pediatrician, I, too, feel the nobility and privilege of my profession, and count myself lucky every day that I am able to do what I do.  But to denigrate lawyers and journalists as somehow less valuable to society is beneath us as a profession.

What of those journalists who help expose quackery in the medical field?  The Chicago Tribune has been running a series of articles recently exposing the dangers of chelation and other unproved methods of autism “treatment.”  The FDA ruled this week that such treatments are dangerous and illegal.

Even if you don’t believe that public exposure by the Tribune and other news organizations helped put the FDA’s feet to the fire, at the very least you have to admit that their reporting will cause doubts in the minds of parents considering such therapies.  Media exposure like that touches far more patients than I ever could.

In his article, Dr. Son takes issue with trial lawyers.  No complaint here.  But he does denounce the entire profession with this statement: “To claim the legal profession as more important than the practice of medicine borders on delusional.”

What of the healthy policy lawyers who helped craft the Medicare bill of 1965?  One may debate the merits of that first step toward national health insurance, but the health benefits to millions of elderly (and an ongoing source of revenue to providers of adult care) cannot be counted as unimportant.

Are the works of these journalists and lawyers so much more invaluable than the routine diagnosis of croup I made last week?  I doubt it.

Furthermore, the medical profession’s high regard for itself has not translated into action on the health care reform front.  Instead of arguing who is more important, physicians or lawyers or journalists, we should be leading the way on health care issues in this country.  Instead, we physicians on the front lines are often the pawns, being moved around by the insurance companies, the government, and large hospitals.

I know I’m valuable as a physician.  I see it in the faces of parents every day.  And it’s not always in the expert diagnosis I make or the quick treatment of a sick child.  Sometimes it’s in the simple caring at the end of chronically ill child’s life.  In moments like these, I know my value.  I don’t need to construct a professional hierarchy to prove it.

Ruben J. Rucoba is a pediatrician.

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  • http://thedocsquawk.com thedocsquawk

    Agreed. There’s enough one-upmanship in medicine already without having to get journalists and lawyers involved. I mean, really? Are you going to try to out argue a lawyer?

    • http://www.aneurysmsupport.com/ Mike

      “Are you going to try to out argue a lawyer?”

      Well, as they say where I come from, Don’t get in a &i$$ing contest with a skunk.

      Sorry, I am not trying to offend anyone or bring down the quality of this blog or the posts of the readers. This just seemed to be the most appropriate response I could think of right now.

  • jsmith

    Grammar and usage watch: Invaluable and valuable are synonyms.

  • rjrucoba

    Thank you. I stand corrected.

  • anonymous

    Tearing down other professions so you can feel superior is just… immature.

    For those who think journalists have it so easy, check out the article at the following link. All I can say is “wow.”

    http://www.reportingonhealth.org/resources/lessons/covering-vaccines#comment-345

  • Matt

    If you do feel the need to tear lawyers down, you certainly couldn’t do any worse than what we do to ourselves:

    http://www.youtube.com/watch?v=nMvARy0lBLE

  • IndiepsychNP

    There is no need to go after journalists and lawyers who were/are in the old boys club when doctors sit at the top of the healthcare heap. I’m referring to us: the nurse practioners, the PA’s, the nurses, the pharmacists, the great many who don’t even apparently merit the prestige to be compared to in some hierarchy match. But that’s OK, nurses have been focused on the patient from the beginning of nursing both clinically and in our public policy/ public health work, so carry on with the grand comparison. We’ll be taking care of patients without any social prestige. It’s not really necessary to patient care….

  • http://www.TheHealthCulture.com Jan Henderson

    Dr. Rucoba – Thank you so much for your sane and much-needed reply. The need to feel superior to others has been the cause of much suffering throughout history and continues to be a source of prejudice, bigotry, hatred, and violence today.

  • rjrucoba

    Jan, thanks for the kind words.

    IndiepsychNP, I think you misunderstood my point: I don’t do what I do for the social prestige, and my post was a condemnation of hierarchies of professional value, regardless of the kind of work being done. I’m the one arguing against ANY sort of “grand comparison.” In addition, I have always had NP partners in all of my jobs, and have been a vocal advocate of NPs and nurses in general (I even married one!).

    The problem with my post is that it was a targeted counterpoint to a prior post, not a comprehensive treatise on the value of physicians vs. lawyers or nurses or truck drivers or senators or anyone else.

    As a bone marrow transplant recipient and frequent user of the medical system, I understand the importance of good nursing care. In the hospital setting, I see my doctor for about 5 minutes each day, but the nursing care is continuous, and makes all the difference in the world. In the outpatient setting, if I want something done, I don’t call my oncologist, I call his NP. As a practicing physician, I know the patients come to our practice as much for the quality nursing care as for the care I provide (though not all my partners would agree with that statement).

    But your comment suggests that maybe this blog needs a new post: a discussion of the nurse-doctor relationship. Maybe the post should come from a nurse. I’d be curious to read more from you.