Over the last couple months, I have often been asked what I plan to do as a recent college graduate. My response has been that I will be attending medical school in Chicago.
“Oh! Medical school!” many exclaim as their eyes light up, “So you’re going to be a rich doctor.”
This response as well as most others I have received seemed to imply that medicine is an ideal profession if one is gifted enough to pursue it. Medicine has had the luxury of being one of the great professions within societies throughout history, along with practitioners in areas such as law and religion. Though some may argue that modernism has significantly transformed these historic societal roles, there is still a great deal of respect and prestige commanded by these positions. Perhaps my view is a bit romanticized, but I think there is value in viewing our future physicians as being called to the medical field to share their talents and abilities rather than being gifted enough to pursue professional prestige and a high salary.
This distinction seems particularly important for professions which deal in the treatment of people. To heal a person, whether it be his body or soul, requires both additional humility and more carefully defined goals. The former is well reflected in the old adage, “With great power comes great responsibility.” Work which affects the lives of other human beings carries with it additional moral and ethical weight.
The second requirement is a result of the former. If a car is broken, for example, it is usually easy to identify one’s options and the implications of such decisions. This is not the case for a human being with a diverse array of needs from physiological to psycho-social. Thus these professions require careful deliberations to determine appropriate goals and limits, and without those goals and limits, there is a greater risk for a lack of congruency, leading to disagreements about the correct place of such professions in a given society.
Approaching a field such as medicine as a simple choice may undermine the humility it requires and further complicate our attempts to define its goals and limits. Studies continue to suggest that a substantial percent of physicians are dissatisfied with their profession due to pay and a growing gap between professional and personal expectations. I think physicians and their patients may be expecting infallible medical professionals who operate independently and achieve financial benefits, whereas modern medical practice continues to demand collaboration and greater humility.
If I felt that I chose medicine to achieve some personal gain, I would be more likely to expect personal benefits which outweigh my sacrifices. Approaching the medical field as a calling shifts one’s focus to the positive impact one can make in his/her community, which may add both to the satisfaction of medical practitioners as well as their patients.
Before the remarkable technological growth of the last century, the medical field was limited in its power. Today nearly every known condition has a course of treatment, many with high rates of success. This newly obtained power has sparked a number of debates over the last few decades about the proper limits and goals of medicine. It is curious to me that conversations surrounding healthcare reform seem primarily concerned with money. It seems that for many economic concerns define the proper place of medicine and we must simply balance affordability and access with innovation.
This cannot be right. Surely we would like to believe that our physicians sincerely care about our well-being and are not simply trying to maximize their profits by balancing our demand for ‘caring’ with their supply. For this and many other reasons, medicine is unique and economics alone will not provide us with the insight we desire. Rather than struggling to answer each ethical dilemma facing modern medicine individually when they arise, I think significant insight can be gained by attempting to trace these dilemmas back to their source and then posing more global questions.
To do so, let us compare the field of medicine to religious institutions. When a young man decides to become a priest, for example, we expect that he felt called to such a life. Yes, he likely could have pursued different professions, but he felt a pull, perhaps even a duty, to become a priest. When his parishioners seek his counsel, we would expect him to be humble to the power of his position and to provide guidance which would best serve the souls of those individuals, according to their common beliefs. The limits and goals of his profession are clearly defined by the doctrines of his religious institution. Although he serves his parishioners, he is not expected to tell these individuals what they want to hear so much as what they need to hear according to the teachings of their church. Medicine shares similar requirements for humility and clearly defined goals, yet we tend to approach this field quite differently.
Perhaps there is something to be gained by asking ourselves to what set of rules and principles should our future physicians answer? I would suggest that physicians should be servants of health and that health be the goal and limit of medicine. Of course defining health in a given society is no easy task; but if such a definition was achieved and universally accepted, I believe patients’ and physicians’ expectations may converge through this understanding, facilitating better patient-physician relationships and overall healthcare.
Much like the priest and his parishioners, patients may instead trust their physicians as servants of their health rather than prestigious professionals hoping to make a lot of money or powerful crusaders against death. Physicians may also face less ambiguity and greater satisfaction serving the health of his/her community rather than striving to achieve a return for their investment. Furthermore we may find ourselves agreeing on more of the tough, ethical dilemmas facing modern medicine.
Thus I conclude not with a magic answer but set of broader questions and a calling to physicians and patients alike to work towards a better understanding of health in our society.
Eric J. Keller will be an incoming medical student.