Let’s heal the health care community

“Wisdom is nothing more than healed pain.”
–Robert Gary Lee

One of the recurring expressions I heard throughout training, from preceptors and attendings to doctors ignoring a lowly medical student/resident eating lunch in the doctor’s lounge, was: “I’m living the dream.” It didn’t take long for me to realize that it was a code meaning anything but. In the last few weeks, I’ve discussed what steps I’m taking towards personal healing and what steps I’m taking to become the kind of doctor I want to be. Now I’d like to discuss my thoughts on what steps we as healers might need to take to heal ourselves collectively and create the kind of health care community we want to be so that we can say we are “living the dream” and really mean it.

We need to start by attending to our own health. Ever witnessed the hypocrisy of an authority figure giving you advice? How seriously did you take them? Exactly. If we don’t maintain a healthy lifestyle, keep up with preventive health care and seek medical help when indicated, then it can hardly be surprising when our patients don’t either. Our role as community leaders will be hollow — based on our credentials and nothing more. There’s another side to this though, all of us healers are also patients; we are the only ones who are able to see the health care system from both sides. We are the only ones who are able to really know whether the standard of care is realistic, what it feels like to undergo the treatments we provide and where we are falling short. Finally, it is essential that each of us be as healthy as possible in order to do more than maintain the status quo; we have a lot of work to do, and it will require all of our combined time and energy.

We need to share our stories, our struggles, and our solutions. We need to share with each other and with our patients and the general public — the time pressures, workload, and the emphasis on maintaining “professionalism” (read: maintaining the status quo) tend to instill silence in us. We know our community is dysfunctional. We know abuse exists. We know, as a whole, that we are not happy people. We need to do more than nodding and smiling and ineffectually venting our frustrations in secret. It’s essential that we bear witness through speaking, writing, blogging in whatever way we can. Even just sharing one-on-one with patients, family, and friends. Patients, lay people, can only see the health care system from the outside. They know when we don’t have time for them, when we’re not listening for them and when we aren’t able to “do anything” for them. They hear about the scandals when they make the news. But they don’t understand why. The result is a loss of trust, hostility and a general reluctance to seek care. The only way we are going to be able to change this is if we can help patients understand the why. We need them to understand that we truly do care. We need to clearly explain the reasons why we have fallen short in the past. We need to demonstrate openly and honestly how we are trying to change. The irony is that many of the problems we struggle with within the health care community are the ones that society at large struggles with. Medicine is not the only dysfunctional institution out there.

We figure out how to address the problems we face, we are able to truly address the underlying causes behinds the health problems of our patients. Health is our area of expertise. We need to step up as role models and community leaders in this regard.

We need to actually start thinking of ourselves as a community. Training and practice can be isolating. Those who practice inpatient may interact with each other more, and there are conferences and CME, but most of the time, we stay by ourselves in our own practices. The only people who regularly move between practices are medical students and residents, who have a lot of reasons to be careful with what they share — and drug reps who have ulterior motives. We need to set aside the competitive, pimping mentality instilled provide each other social support, for often times, we are the only ones who know firsthand what our troubles are. We need to learn how to respect a diversity of opinion and practice styles, but we also need to learn how to collaborate together when necessary. We need to figure out to communicate consistently about the big things, like appropriate antibiotic use, appropriate controlled substance use and the adhering to the ever-changing practice guidelines. We need to figure out how to practice the standard of care together.

Finally, we need to step back and look at the bigger picture every once in a while. It’s too easy to become myopic about the current state of affairs. Naturally, we focus on each individual patient that comes before us successive patient we encounter and the current best practices to treat them. But medicine, both as a culture and as a set of treatments, has changed over time. Medicine is practiced differently around the world. As we come to the realization that we are not the kind of health care community that we want to be, we need to understand how we got here. Essentially, we need to take out our history in order to diagnose and develop our own treatment plan. We need to understand how and why medicine changed over time. We need to understand how and why medicine is different in one part of the world than another. We need to understand what aspects of medicine are universal. We need to understand all these things because it gives us the perspective and potential healing solutions as we move towards a healthier future.

Liz Hills is a family physician who blogs at Heal Thyself.

Image credit: Shutterstock.com

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