These are the moments why we practice medicine

When I was a new attending, an older man came to see me as a new patient.  He had not seen a doctor in over thirty years and was experiencing worsening chest pain that first occurred when he walked upstairs but had progressed to pain at rest.  An electrocardiogram in the office showed signs of ischemia, and I advised him that I wanted to call an ambulance to take him the emergency department.

The patient refused, and I found myself doing something that I would not have the time nor the courage to do now.  I convinced him to let me walk him to the emergency department, left my office, and walked the several blocks to its entrance where he was swiftly triaged, admitted, and later diagnosed with coronary artery disease.

I shared this story and the impact of this moment during a storytelling event at a recent medical conference. I was amazed by the response from both attendees of the conference and others who later heard my story online.  Ever since, I have wondered why I received such a strong response, particularly from physicians, and have concluded that it is because every physician can identify with this story. Every physician has had similar moments when she goes beyond her professional duty, feels proud to be a doctor, and proud to profoundly impact a patient.

I have started to call these moments “our greatest moments” in medicine and, I’m sure, even without describing what they are, every doctor knows what I mean.  They are the moments when we remember why we practice medicine, the moments when we remember that what we do is important and meaningful, and the moments when we forget about the hassles often associated with the modern day practice of medicine.

As a health services researcher and an internist, I feel like I am always pointing out problems in medicine: quality of care is poor, patients cannot access their doctors, and costs are out of control. The list goes on and on.  It’s no surprise that given the constant focus on problems, we have an epidemic of physician burnout and dissatisfaction.

Numerous studies have demonstrated that burnout and dissatisfaction are pervasive among physicians. A national survey of physicians found that almost half meet criteria for burnout, and almost 40 percent are dissatisfied with their work-life balance. In another national survey of surgeons, 40 percent displayed signs of burnout, and 30 percent met screening criteria for depression.  Burnout and dissatisfaction not only affect physicians themselves but are also associated with higher rates of medical error, lower quality care, and lower patient satisfaction.

If the next era of medicine is to substantially and rapidly improve quality of care, reduce waste, and engage patients, the medical community needs to find ways to combat dissatisfaction and burnout in order to keep the physician workforce engaged and productive.  One way to do so is to help doctors remember the power of their profession and why they pursued it in the first place.

This is where our greatest moments come in.  Imagine a way for doctors to realize and remember their greatest moments in medicine and find a way to share them with the medical community at large. Single stories are a simple, manageable, and tangible way to reflect on our experiences. Focusing on a positive and significant moment can serve as a reference point to anchor each physician – particularly when practice becomes challenging.

Story sharing events have exploded across the country, and there are countless outlets for sharing stories on the internet.  However, there is currently no platform for physicians to share their greatest moments in medicine; but perhaps it is time. If we started a national interchange of greatest moments, we may, in fact, begin to combat dissatisfaction and burnout — not by intense programs, major changes in our organizations, fewer hours, or increased pay.  We might be able to combat these issues by helping doctors remember their calling, their professionalism, and their humanism — one story at a time.

It has been several years since that walk to the emergency room. My practice has changed substantially, and I would never have the time to leave my clinic now. I struggle with the constant feeling of trying to do too much with too little time and too few resources. I certainly have moments of dissatisfaction and burnout, and I have found that my patient story helps me persevere and hope that others’ stories will help us all persevere.

Tara F. Bishop is an internal medicine physician who blogs at her self-titled site, Tara Bishop MD.

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