We like to say good things; we try to make normative to our profession to do the things that should be done. Many of us are saying that physicians should be advocates for their patients and communities outside of the clinic.
Sounds good right? Unfortunately, what sounds good is not always a reality on the ground. I think most physicians agree that some from of advocacy for patients outside the clinic is ideal. What we should be asking is whether this is possible.
Some may say that physicians are uniquely positioned to advocates for their patient’s health outside of the clinic. Our medical training gives us an understanding of medicine arguably better that any other group, we are trusted, and we have the ability to integrate our biomedical and clinical training with our expanding knowledge of the social determinants of health. Yes, I too agree that we are uniquely qualified to advocate for our patients outside of the clinic. However, our positions in society paradoxically make it difficult for us to do so.
We live in a profession that asks for a lot from us. As soon as we enter medical school we are engrossed in our activities and consumed by our commitments. Those who are so close to us suddenly become so distant: Even if they live across town. Residency is no different. Even with recent residency work-hour limits, we are still expected to work a tremendous amount of hours in an attempt to learn a body of knowledge that truly is infinite. After residency, we are thrown to the insurance companies and insurance boards.
We haven’t even considered the unbelievable debt burden new graduates are under. According to the AAMC, 2014 graduates have average and median medical education debts around $180,000. This is a far cry from just 11 years ago, when the figures for both were under $110,000.
Wait, we’re not done. We still have families, significant others, children, and friends. We still have bills to pay and mouths to feed. We still have to advocate and take care of ourselves. After all of this, we are then able to advocate for others. Once clinic duties are up, then we can spend the time left working on other non-clinical issues related to medicine like policy and community advocacy. Some may seem perplexed by the fact that physicians “talk the talk” in regards to advocacy beyond the clinic, but don’t always “walk the walk.”
Well I think its simple. Some just don’t have anything left to give.
Michael McClurkin is a medical student.
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