A guest column by the American College of Physicians, exclusive to KevinMD.com.
As part of my role in International Programs at the American College of Physicians (ACP), I have a unique opportunity to travel frequently and engage with internists around the world. In fact, I am writing this while almost 7,000 miles away from home, participating in the 4th Annual Qatar Internal Medicine Conference/Best of ACP’s Internal Medicine Meeting in the city of Doha.
Changes to U.S. immigration policy and travel rules along with uncertainty around our own health care system have certainly made this an interesting time to travel internationally. During visits to other parts of the world, I’ve made it a point to actively seek out the thoughts, feelings, and perspectives of our international medical colleagues. Specifically, how they view what is happening in our country, the potential impact these changes may have on them personally, and how they think all of us as members of a worldwide community of physicians will be affected. Much of what I’ve heard was not unexpected; however, I’ve also heard so much more that truly surprised me.
Not unexpectedly, most of those whom I’ve talked with have expressed difficulty in understanding the reasons why many of these decisions have been made; I’m frequently asked to try to explain the likely motivation and meaning behind them, and whether they reflect the feelings of the country in general. There is also genuine concern that shifting policies may adversely affect our ability to continue working together, not to mention how they might affect these physicians personally or the patients for whom they care. Plus, there is worry about how potential changes to the U.S. health care system might adversely affect the quality of medicine in America which, despite its myriad issues, remains highly respected around the world and is one of the primary reasons they find collaboration with us so valuable.
What I have found truly surprising is that in many ways, these changes may actually be bringing us closer together as a global physician community. Why might this be?
It doesn’t take much international travel to realize how different medicine is outside of the U.S., ranging from how physicians are trained to the marked differences between countries and regions in terms of how medicine is actually practiced. For example, some countries have well-organized and efficient health care systems (think Cuba), but are remarkably under-resourced, whereas more resource-intense countries (such as ours) struggle to provide the highest level of care to patients in a manner that avoids wasteful practices. This doesn’t even begin to consider factors like epidemic diseases, natural disasters, and social/political upheaval (such as in Venezuela and other parts of the world) that challenge physicians as they work to care for patients.
Interestingly, our international colleagues seem to inherently understand that all doctors must deal with a variety of specific issues in the system in which they practice, (whatever they may be), but that these challenges do not alter the sense of mission and core values we share as physicians. We in the U.S. are not immune to our own particular set of challenges. So instead of anger, suspicion, or distrust, I’ve actually experienced a sense of empathy from them since they are able to relate to the experience of dealing with factors that significantly affect them and their patients but are not necessarily under their control. In fact, in many instances, they express great concern about how these same issues are personally affecting me, other physicians in our country, and our ability to care for patients.
Perhaps more importantly, the shared mission and values that we hold as physicians seem to be strengthening the bonds between us as an international community. What has always impressed me in my international medical travels is that beyond the obvious differences in the structure and function of health care systems worldwide, the essential elements of medicine are remarkably similar everywhere. Just as I hope that the major drivers of physicians in our country are the ideals of the primacy of patient wellbeing, honesty and integrity, providing the highest level of care possible, and maintaining a high level of professional performance, I find that these are the identical motivations shared by physicians in other parts of the world. This observation brings to life one of the many prescient quotes by William Osler who commented over a century ago in in 1904 that: “Medicine is the only world-wide profession, following everywhere the same methods, actuated by the same ambitions, and pursuing the same ends.”
It is unfortunate that current events have required us to engage our international colleagues in discussions of how they feel about us and American medicine. However, as is often the case, sometimes great good comes out of the potentially negative. I have truly been heartened by the fact that in these challenging times, our global, shared commitment to medicine is actually pulling us closer together and not driving us apart.
Philip A. Masters is vice-president, Membership and International Programs, American College of Physicians. His statements do not necessarily reflect official policies of ACP.
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