What new doctors don’t realize. And it’s holding them back.

A new doctor, fresh out of a top residency and fellowship, wants all the right things at the wrong time.

She wants to be busy, with lots of patients, operating every day. In fact, it is better not be busy, and instead to think long and hard about each patient, listening, pausing, recommending non-operative treatments and being patient. Doctors learn the most from the patients they take the time to truly listen to and care for with extreme attention and lovingness. They learn nothing from those they have little time for.

A new doctor wants to market himself. He wants to tell the world how well trained he is, how up to date he is with the literature, how knowledgeable he is about the latest techniques and tools. What he should really do is read more than he speaks, listen more than he argues, and apply the accepted techniques, while ever so slowly introducing novel approaches. He should stay under the radar, find and cultivate the wisest mentors, stand behind the pillars of the community, and gain their trust for several years before challenging and eventually leading them.

The new doctor wants to computerize, modernize, electronic medical ‘recordize’, and robotize every aspect of medical care. What she doesn’t realize is that most of the current digital data is not compatible with any other system, can’t be moved to a new hospital, and is subject to viruses, malware, and corrupted programs. Mostly likely, 20 years from now, all her computerized records will be unreadable, inaccessible, and useless. She must take note of the growing trend of a computer humming between every doctor and their patient, further distancing the doctor from learning the subtleties of the patient and of medicine, and she must find a way to overcome this.

The new doctor wants security while making money, independence while having a job, freedom to practice while contracted with insurance companies. What he doesn’t realize is that the security of working for someone else can evaporate in the first downsizing; the independence once visualized in medical practice is lost when taking a paycheck, the freedom to practice crushed when contracting with the lowest cost bidders, i.e., the health plans. The socialization of medicine is a choice a doctor makes when they choose not to work independently.

The new doctor wants to lead her field. She understands that performing research, presenting papers, writing books, and lecturing are the paths to stardom. She doesn’t understand how to do this while also practicing full time and meeting the financial and personal demands of a new practice and maybe a family. What she really needs to do is accept that to be both a fabulous doctor and a researcher one must commit full-time to both, integrating the research directly into the practice and setting the practice up to permit the research. It is all possible, and definitely worth it, though the sacrifices are usually financial and personal for many years.

New doctors want to be all that they can be on day one. The reality is that each decision on how to become the superstar affects the likelihood of getting there, and that patience, exquisite care of each patient, quiet tactical maneuvering, phenomenally hard work and a low profile early on under the guidance of wise mentoring is by far the best way.

Kevin R. Stone is an orthopedic surgeon and chairman, Stone Research Foundation.

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