While running several times over the past week, I have thought carefully about our profession. I cannot imagine having chosen any other profession than medicine, nor any specialty other than internal medicine.
But that is me, is it you?
A medical tweeter than everyone should follow @medicalaxioms had these tweets recently:
If you become a doctor for wealth or prestige, you are going to live a sad and angry life. Happy doctors feel chosen to fulfill a purpose.
You are in this profession as a calling, not a business.
There are better ways to make money than medicine. Medical school and residency occupy at least 7 years during your 20s, while your friends are making money.
Becoming a physician does give one some immediate prestige, but prestige would mean nothing if the daily work was miserable. Prestige does not cure misery.
The first criteria for becoming a physician should be that you really want to help patients. How do you know? It helps if you have spent time with a physician. It helps if you have worked in health care. But ultimately it really is a personality consideration. Do you really want to help others?
The second criteria for becoming a physician is that you enjoy the mental processes involved in doctoring. As doctors we solve diagnostic puzzles, and use our knowledge to determine the best treatment options. Excellent physicians continuously expand their knowledge. We learn from our patients. We decipher their stories, examine them, and combine those activities with the tests we order. Then we persist in the thought process, following the patient to be certain that our assumptions are correct.
The third criteria is humility. We are never as good as we would like to be. We will make mistakes, hopefully not major ones. We must own those mistakes and correct them if at all possible. As new information becomes available – new symptoms, new physical findings, new test results – we must be willing and eager to adjust our approach to the patient.
The fourth criteria is our willingness to educate our patients. Being a patient is often very scary, especially in the hospital. We have a responsibility to help our patients through the medical maze and make certain that they understand (at their educational limits) what is happening and what we are doing.
The fifth criteria is accepting our limits. We cannot cure every disease. We cannot always save a life. But we can alway comfort. We can always strive to improve quality of life. We can always care, and let our patients know that we care. We can always comfort. And we understand that palliation is a success for the patient.
These are my beliefs as an internist. Other specialties would like have different criteria.
In April, I will attend my 40th medical school reunion. I remain thankful that I was able to tolerate the first 2 years of medical school and in my 3rd year found out who I was and who I would become. If you are a medical student or a pre-med student, I hope this helps.
My physicians complain about the bureaucratic hassles tainting medical practice in 2014. Danielle Ofri has a wonderful op-ed on this subject: “Adventures in ‘Prior Authorization’.”
But most physicians still love spending time with patients and helping them. Can you overlook the problems and still love doctoring? I hope that you can.
Robert Centor is an internal medicine physician who blogs at DB’s Medical Rants.