“There’s no passion to be found playing small, in settling for a life that is less than the one you are capable of living.”
Amidst the chaos of our noisy world, it’s hard to know where to begin a new career as a healthcare professional who’s about to inherit an American disaster called healthcare. And it’s likely that in a few years, you may find yourself lost inside a daily bombardment of unsettling, paradoxical messages, and then begin to wonder, “What just happened? What did I do wrong?”
Many physicians today are asking themselves this very question.
I recently had a job interview with a newly graduated physician assistant. As we talked, her eyes widened. She shared with me her recent experience on a pediatric rotation.
“All those doctors did was ask these poor kids how they were doing with their prescriptions for ADHD (attention deficit disorder). And then they just wrote another prescription! Some of them were only in grade four! I wanted to say something, but…”
Her voice faded.
Our society is filled with incongruent messages. Nowhere is this irony more evident than inside healthcare. We’ve been taught to believe that a physician should be at the center of a healthcare delivery model. We’ve been taught to prescribe, fix and cure. We’ve been taught to think that by working backwards from disease, we will be able to prescribe health.
Our word is God. And we teach you, our fledgling off-spring, to believe it.
Inside the stress of studying diseases, cures, fixes and treatments, the lines of health practice have become obscured. You’ve been taught to deliver paradoxes for health in the form of prescriptions for disease. You’ve been taught to diligently search for disease as soon as a patient enters your office. And you’ve been taught to declare, upon receipt of all those negative tests, that your patient is healthy!
Fast forward to today.
Inside America’s now crumbling model of inefficiencies, disease epidemics and sky-rocketing cost structures, you will exist. Your role models, we doctors, are burning out at 80-90% job dissatisfaction rates. Many would never in a million years recommend this profession to their kids.
You’ve seen their faces on rotations, in offices, their monotonous voices repeating these words again and again, “What can I do for you today, Mrs. Smith? Why don’t you try this pill for your depression?”
But the real question is, “What just happened? What did I do wrong?”
It’s tough to emerge intact from healthcare training today. But despite a crumbling institution, there’s a ray of light gleaming from under a door that’s just waiting for you to unlock! The key, however, isn’t easy to find.
Our society is intolerant of individualism. Ironically, America has been founded upon this very ideology. But inside a profession that stands on paternalism – - father knows best – - we don’t easily tolerate dissent from our trainees, let alone our patients. These messages sink deep into the very curriculum that you’ve just studied.
There is a fix and cure for everything. We declare that we will find it if we spend trillions and trillions of dollars, keep our mouths shut, and keep forging ahead without stopping to see the big picture.
We don’t question our preceptor’s choice of pills over simple words of encouragement and support. We don’t question their referrals to surgery instead of chiropractic manipulation; their dosage of narcotics instead of acupuncture and massage. We don’t understand how to practice health as democratic providers who can work together as complete equals from both alternative and conventional fields, without resorting to turf wars.
We only know science and medicine. And we’re taught to hold our tongues when we want to question our forefather’s practices: “But doctor, isn’t there a better way to do things?”
What happens if you don’t agree with that prescription you’re about to write anymore? What happens if you have a very different idea of who should be helping your patient, and that someone isn’t your orthopedic physician preceptor but a licensed acupuncturist instead?
That’s an uncomfortable thought.
Our future in healthcare is still unknown. Maybe, you should be questioning these messages. Maybe you should disagree with what you’ve just learned. Maybe you should be searching for that hidden key.
The question isn’t so much “What do you want to do in your career?” but more, “Who exactly are you? How much courage do you have to stand against a several trillion dollar industry that keeps searching for pills, fixes and mechanical cures using outdated Newtonian physics instead of accepting a different approach to disease and health, one that’s infinitely more cost-effective?”
I used to believe that my preceptors knew everything. I wanted to be just like them and so I never questioned what they told me to believe. Much of it was delivered with sarcasm if I didn’t know the answer, or I thought about things very differently than they did. As I look back at my journey, I only now realize that the answer to the question was inside me all along. I wasn’t strong enough to unlock the door.
Physician assistants and nurse practitioners will inherit the primary care market in America in the next few years. Over 90 percent of the total medical care in our country is delivered here. At 3 to 1 specialists to primary care, America has not invested in a sustainable base to allow a smooth transition to occur. At the same time, modern disease is now in epidemic proportion, waiting for end-stage disease care rather than an entirely new paradigm from which we should operate. The curriculum that you’ve been taught is already archaic because the healthcare delivery model it has been based upon is grossly outdated. You, dear graduate, are being asked the toughest question of your life.
Who exactly are you? And what do you stand for?
Me? I believe in forging my own destiny at all cost. I believe in questioning dogma, standing strong in my beliefs and for my patients, not my institution … although it’s not very popular amongst physicians to do so. You get a lot of flack. You get rejected.
But your future is yet unwritten. To be ahead of the pack, learn from those who have minds as expansive as the sky, and not from those who hide their right to independent thought behind the myopic lens of history, operating as automatons of a dying breed.
Can you choose to write your own story, dear graduate, at all cost? Can you find the key? If you do, one day you just might shout from the rooftops, “This is what I did right! This is who I am!”
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