No one cares about the doctors


I love my doctors.

I have an undiagnosable autoimmune disease. It’s mostly manageable, my lab work is perfect, and I rarely get sick. I get allergy shots and take blood pressure medication. I always have at least low level, mostly familiar, physical symptoms. Occasionally a new one appears. Sometimes it is scary.

I could have sued any or all of my doctors over the last decade-plus. I could be “livin’ large.” They haven’t figured out what is wrong with me. They made mistakes, which sometimes caused symptoms and certainly did not resolve my issues. It took several years to get me stabilized.

So why do I love my doctors? Why wouldn’t I sue them?

I could see that they were trying to help me. They told me that they were trying to help me. They coordinated with each other. They comforted me when I was distraught. They looked at my issues, flexibly, from all different angles. They consulted with other colleagues. They persisted. They never gave up. They cared. They have made my life livable.

I needed them, and I still do. I am so grateful to them.

This point of view is missing from the national conversation about health care. I interviewed 50 doctors for my book, and they told me all about it. Their compassion and dedication flow out of the pages. Yet, that doesn’t seem to matter or be heard. As one of them said, “No one cares about the doctors.”

Those of us who went to college remember the pre-med students. They were the ones who studied all the time. They took multiple difficult science courses, some of which were “make or break,” requiring an “A” to stay competitive. As one of my interviewees said, “Most people aren’t committed at such a young age.” It’s not like this magically changes after they complete medical school and residency. One telling interview item from my book was, “Please tell me about a typical day or week for you.” This produced astounding responses. The typical day for one doctor involved rounds at the hospital, seeing patients in the office, doing chores, making phone calls, checking messages and lab results, family calls, other doctor calls, then back to the hospital. One doctor told me “It’s 24/7.” Another one stated, “It’s not really a job. It’s your life.” And another said, “You give up and miss out on a lot.”

The pressure to perform and to be correct 100 percent of the time is beyond belief. I know that I couldn’t withstand it. “This society accepts no mistakes. It’s the only job where you cannot make a mistake”, said one doctor. “You are responsible for things that you cannot control.”, said another. And when I inquired about lawsuits, those of my interviewees who had them stated that although they emerged unscathed professionally, the “stress was horrible” or one felt “violated.” As a result, “Younger doctors are experts in defensive medicine, rather than the real issues.” While many of us are still under the impression that all doctors are rich, my interviewees reported declining salaries, trouble keeping their doors open, and of course, the overbearing presence of massive debt accrued from attending medical school.

How is any of this right? Does this make sense? It’s some combination of the “terrible twos” and adolescence. We are supposed to be a society of adults, who know that we are not the center of the universe, that sometimes we have to wait and be patient, and that we need see the perspectives of others. This is all part of normal development. Instead, we want what we want, and we want it now. And we want it to be perfect. When we don’t get it, we rebel and lash out. Sound familiar? This attitude applies to health care. So, look at it this way: one of the most important aspects of the health care crisis is that we have an ever-increasing doctor shortage. They are being driven out of practice. This is partially due to our developmental immaturity.

Is this what we want? I know that I don’t want it. How can we expect people to sacrifice and then work under the pressure that our doctors are working? And to top it off, to be ever caring and competent. Research shows that emotions, stress, pressure, mistreatment, disappointment, futility–call it what you will–all impact problem solving, critical thinking and performance. Should our doctors be expected to be superhuman in this regard as well? What do my doctors need besides training and clinical competence to help with my uncharted disease? In fact, what do doctors need to help any of us with anything? Well, they need to be able to think. Who could think under current circumstances? But we expect that, and in my opinion, we typically get it.

We all need to stop pretending that it doesn’t matter how we treat our doctors. As one of my interviewees said, “We are used as pawns in the system. No one cares about the doctors.” We, the patients, are the ones who pay the price for this callousness.” There was a social pact in place,” said one interviewee. “We provided care, and we had a comfortable life. That pact was broken. The deal was broken. So now there is a new generation with a new attitude: We will provide care when we want to provide care. 9 to 5 and no weekends.” If this isn’t what we want, we need to rethink how we treat our doctors and start caring about them again. We need to think and behave like adults and do what is best for all of us, including our doctors. This needs to be part of the national conversation about health care. Our lives depend on it.

Peggy A. Rothbaum is a psychologist and can be reached at her self-titled site, Dr. Peggy Rothbaum.  She is the author of I Have Been Talking with Your Doctor: Fifty doctors talk about the healthcare crisis and the doctor-patient relationship.

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