In a little over a week, I will be starting medical school and taking my first committed and substantial step (at the very least, with respect to time and financial commitments) toward joining the ranks of physicians in the U.S. I take this step accompanied by a number of friends from college and high school who share similar aspirations of becoming physicians, each with a varying distribution of motivation from each of the following: prestige, stable salaries, delaying the inevitable job hunt for another decade, and changing the world – whether through providing the best care for individual patients or changing medical practices and health care on a local, regional, national, or global scale. Like most students, a part of me thinks that I should buckle down, close the shutters, and study till the painful examination process is complete and I have a medical degree to prove my authority, ignoring any and all unnecessary bits of information. Physicians like to differentiate themselves from all other medical practitioners and academics who use the title “doctor”, and looking to the training process alone, it’s not hard to see why: few other professions require such extensive training, particularly with respect to the massive amounts of information that must be internalized in a very short amount of time. On top of the duration of the training and the scope of information covered, there are also the emotional, psychological, and physical challenges that test (relatively) young physicians-in-training and harden their physick-al fitness.
But what do we lose in the process of training? My first guess, preparing to step through the entrance, is that many future physicians lose perspective and connection. While they may learn a lot about the intricacies and ambiguities of medicine and health care, they sometimes forget where they came from or what that origin means. I think this disconnection plays out particularly strongly in the everyday manifestations of the doctor-patient relationship: like some college professors stuck in their ivory towers, some doctors don’t bother to truly communicate with their patients and help them understand what is going on with their bodies. However, sometimes this is due to time constraints, or fatigue, or simply believing that the patients don’t understand or don’t want to know. Hospitals and health care providers are now encouraging patients to take a proactive role in their own health care to make sure that they ask all the questions they have and have all of their questions answered. While this increased communication is needed, it also seems to breed suspicion and distrust: patients are ever-alert to see if their doctors are mistaken in their judgment, hence the complaint, “Everybody’s a doctor.” This tendency to distrust, of course, is fundamentally counterproductive since it frequently inhibits a single physician’s ability to direct the recovery of his or her patients.
On a fundamental level, the relationship between physicians, patients, and society must change and evolve to fit the needs of our society and its health care system. In the nineteenth century, American physicians practicing “heroic treatments” learned that the people could no longer blindly place their faith in the ability of physicians to always do what is right to heal them. Throughout the earlier years of the twentieth century with the advent of Germ Theory, physicians found that they needed to take a proactive role in promoting the scientific discovery of the origin of disease through public health policy and changes in medical practice in order to best serve their patients. Physicians can play numerous roles in society, but they also can be distrusted and heavily criticized, whether out of jealousy, mistreatment, or doubt about their underlying motivations. However, among the various factions and forces driving changes and policies in health care (the local, state, and federal governments; managed care organizations; pharmaceutical and biotechnology companies; hospitals; patients; and physicians), I believe it’s safe to state that physicians rank the highest with respect to emphasizing and prioritizing the needs of patients – in other words, all of us, collectively and individually.
With this in mind, it’s important for physicians at all levels of the health care system to be leaders: to be proactive in educating patients, supporting medical and health care movements, and shaping public policy in addition to their clinical care and research responsibilities. This is one effort on my part (along with the Next Generation) to press forward towards change for the better: in giving myself time to reflect on my medical experiences and training, a key aspect of medical education that is being reemphasized at this time, I hope to provide you with insight on medicine and health care and what it means to you. As a physician-in-training, I believe I’m ideally suited to this task: I still have the distinct perspectives of the patient, family member, and skeptic fresh in my mind while developing the knowledge base and perspective of a physician. Additionally, I will draw from my experiences as the Editor-in-Chief and Founder of the Next Generation, my summer internship at the New England Journal of Medicine (the most influential clinical research journal), and my experiences with patients, physicians, hospital staff, and administrators during volunteering and shadowing opportunities.
Alright, here I go! Thanks for reading, and please return often and much.
~ Sincerely, Apollo