Last week I finally got around to watching La La Land. As a fan of musicals, I had wanted to see it for quite some time, and before I stepped into the theater, I didn’t know what it was about nor what kinds of reviews it had been getting. Spoiler alert: Don’t read on if you haven’t seen it and intend to watch it (and I’ve never told anybody before not to read my blog, but the movie is so good, please watch it before you read this!).
Very rarely would I use the word “masterpiece” to describe a movie, but La La Land would be it. The storyline involves two main characters, brilliantly played by Ryan Gosling and Emma Stone. It has absolutely everything you would want in a movie: a riveting story about persistence and overcoming odds, great music and choreography, fantastic screenplay — and yes, a love story all while being a light-hearted and a family movie. The ending is particularly profound, a cruel and accurate depiction of reality that would have even the most hard-nosed critics feeling emotional. La La Land is up there with the best.
But this being primarily a health care and medicine blog, the story did get me thinking a little about the situation that physicians find themselves in. That’s because the main plot revolves around both Gosling and Stone pursuing their dreams. Emma Stone is an aspiring actress and faces a monumental struggle chasing her goal. After much heartache, she finally lands a role which is unique and enables her to evolve independently into her character and thus show off her talents to the world. She soon becomes famous. As for Gosling, his dream is to have his own jazz club. He starts off as something of a nobody, and after several experiences, including being part of a rapidly growing touring band with huge potential, he decides that dancing to someone else’s tune is not for him. Hence, he eventually leaves that apparently secure life to open up his jazz institution.
The reason why certain movies do well is primarily that the audience can relate to the underlying story and identify with the characters. Away from the love story aspect to this production, the career truths embodied in La La Land are very relevant to physicians pursuing their ideal work scenario. Let’s draw the following parallel: Over the last 10-20 years, we’ve witnessed an epidemic of physician burnout and job dissatisfaction. This has correlated directly with physicians losing autonomy and independence, i.e. the move away from small private group practice, to being employed, often by large corporations. All against a background of exponentially increasing regulations and bureaucracy.
Speaking as someone who has done this job now for many years and worked in every type of hospital and health care system along the way. I’ve come to one simple conclusion: Physicians can never be happy as controlled employees with the inevitable loss of autonomy and barriers that are placed between them and their patients. There is just no way around this. The more you attempt to make physicians into “assembly line workers” and take them away from patient care (whether it’s because of dreadfully designed electronic medical records or other mandates), the more physicians will hate what they do, especially because physicians are among the most intelligent, hard-working and dedicated professionals in society. It’s a simple fact.
The health care system must allow doctors to be doctors and practice the medicine (the art) that they dreamed about when they started medical school. And importantly, do so in an autonomous fashion. Just as how Ryan Gosling and Emma Stone only reached true career fulfillment once they were allowed to become independent, staying true to their talents and dreams. The question is, how do we take doctors to their La La Land?
Suneel Dhand is an internal medicine physician and author of three books, including Thomas Jefferson: Lessons from a Secret Buddha. He is the founder and director, HealthITImprove, and blogs at his self-titled site, Suneel Dhand.
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