Don’t Be A Docta-Hata

If the extent of “premed” student-bashing in college is any indication of future career experiences, I’m in for a rough ride, as are the rest of my future colleagues. It’s easy to pick on the premeds: the stereotypical premed is cut-throat, aggressive, unscrupled, doesn’t play by the rules, and spends all of his or her time studying in the library or cooped up in his or her room, studying. “Bookworm” has too innocent a connotation. There’s something very seedy and almost evil about “premed” that oozes off the tongue when you say it.

Personally, I find this stupid. A lot of the sentiment stems from a mixture of jealousy (of future salaries or prestige), inadequacy (at feeling unambitious or not hardworking in comparison), and skepticism (of the claims of premeds, that they “just want to help people”). Justified? Maybe, maybe not. At the very least, college students who attempt to find a career in medicine (as a physician) have a hard road to travel, some harder than others (if they’re not born into relative affluency or blessed with good schooling). They’re typically ambitious, hardworking, and probably appear one-sided. However, you see what you want to see, and for me, I see a lot of people who genuinely want to do something productive for society: people who want to relieve suffering, find cures for terrible afflictions (or as Jon Stewart put it, “terror-ble diseases”), and show that they care about other people (and that they’re willing and capable of doing something about it). Fast-forwarding a decade or so of medical training later, does this skepticism and criticism originate in questions of personality and professional approach or questions of qualification or erroneous judgment?

I do think that the principle of using reason is important. In many cases, particularly with people who have spent a lot of time in an academic environment that stresses skepticism, I think that many people choose to be skeptical but fail to maintain a perspective of the larger picture. For example, when you go to see your doctor, how do you communicate with him or her? How do you approach that interaction? Patients are encouraged (by a variety of parties) to take a more active role in their own care, and many interpret this as a call to do extensive online research, be wary of every word the doctor says, and seek second, third, or even fourth or fifth opinions (from other doctors).

How useful is this? Doctors have to be careful with their wording: they have to say, “It is my opinion that this is… and you should…”, leaving it up to the patient to have the final say. In many ways, this is what it should be: every person has the right to make their own medical decisions when provided with the best available medical advice. However, is this what most patients want? Having been a patient myself many times over a period of several years when I accumulated substantial amounts of higher education, I have found myself wanting more information about my illnesses and condition, but not necessarily doubting what the doctors say. I have admitted to myself that I don’t know everything about how my body and how diseases work. I also realize that doctors don’t know everything either, but it’s always clear that they know more than me, the patient.

This suggests that they will always have a better judgment on health matters, with one important caveat: this judgment relies on the patient’s willingness to provide all of the necessary information. In the TV show House, the title character, a disgruntled and misanthropic physician, repeatedly tells his protéges that “Everybody lies.” And in the universe of the TV show, this is the universal truth: in almost every episode, the complicated medical cases at hand could be solved within the first five minutes of the episode if the patients had taken the course of full disclosure. But this is a difficult question for patients? What information do doctors need to know? Matters of health, in our culture, are exquisitely personal and embarassing: most of us don’t expose our health profiles in public (unless we’re confident that we are supremely healthy, which is a rare find), especially if it affects our careers or our images in the eyes of others. However, patients should trust their doctors to be confidential with their health information (there are increasingly more regulations to eliminate “elevator talk” about patients and protect patient confidentiality), and they’re risking their health if they aren’t honest with their doctors.

It’s not just up to patients to change, though. Doctors also have to reevaluate how they approach their patients: Am I asking the right questions? How can I more quickly and effectively gain the trust of my patients? How do I make them more comfortable? What information am I missing to make the proper judgment call? For the most part, doctors have a very limited amount of time with each patient, so they need to work fast and make sure that they’re not making any mistakes or forgetting any important questions. In the best interest of both parties, both physicians and patients need to trust one another fully: to maintain privacy, disclose all of the needed information, and work together toward improving the health of the patient – the goal that both patients and physicians share and place as the first priority.

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