American College of Physicians: Internal Medicine — Doctors for Adults ®

Advertisement
Monday, February 10, 2014

How a quote from a famous Swedish diplomat is something for ambitious doctors to live by

The Swedish diplomat Dag Hammarskjöld is widely considered to be the epitomy of a global diplomat. He served as the second Secretary-General of the United Nations, but sadly died during his term in a plane crash in 1961. He is one of just three people to be posthumously awarded the Nobel Peace Prize. John F Kennedy called him “the greatest statesman of our century”. Considering the turbulence of the first half of the last century, that’s quite an accolade.

If you don’t know very much about Mr. Hammarskjöld, his life story makes fascinating reading. He was a man of great integrity who worked tirelessly on several peace projects after World War II. Many wise and thoughtful quotations are attributed to him, some of which are actually very relevant to medicine and health. One of them is about how “constant attention by a good nurse may be just as important as a major operation by a surgeon.” Few would disagree. Dag Hammarskjöld was a man who understood the nature of humans and the complexities of our world.

But back to medicine. The job of a physician is ultimately one that is about everyday human contact. It’s about as frontline as you can get. As our health care system changes rapidly, many doctors are increasingly moving their careers into new realms. These include fields such as health care administration, resource planning, quality improvement, and health care information technology—all very important areas where doctors can no doubt make a huge difference.

Those doctors who are exploring and progressing in these areas often find themselves facing a dilemma. They need to divide their time between clinical practice and their other career aims. The two can, and frequently do, conflict. I’m sad to say that I’ve seen many doctors open about their desire not to practice clinical medicine, and use such alternative career paths as a way to get away from seeing patients. That’s a terrific shame. I’ve found this happening particularly in health care IT (which also leads to the question why anyone who seriously enjoys sitting in front of computers more than meeting real people would have become a doctor in the first place!)

After so many years learning the fine art of medicine, doctors should always think twice about saying goodbye to clinical practice, not least because medicine is a practice that can easily be lost after just several months away from the frontlines. I’ve seen it happen to many people I know. It’s very difficult to return after walking away. Often they console themselves that they are working towards a “higher cause” in health care with their other career goals.

There is of course nothing wrong with a doctor, or any professional for that matter, wanting to explore ways to improve the systems that they are working in. By doing this, they can not only help one person at a time, but can actually in theory save a whole population. It seems like a great cause to be working towards when we are talking about improving a whole hospital or even an entire health care system.

Doctors can do this by working in a number of capacities—as administrators, for the government, or even for private companies—all geared towards advancing health care in some shape or form. But what about all those years of medical education and training? The labor of medical school, long lecture schedules, late night studying, the never-ending exams. Every doctor remembers those days of constant hard work just to be able to call themselves “doctor.”

In reality however, the two careers do not need to be mutually exclusive. The best health care administrators and planners that I’ve ever worked with have been the ones who manage to balance the two (often they’ve been the best doctors as well). It’s perfectly feasible and there are countless examples of such physicians all over the country. And we’re not talking about a day or 2 here or there of clinical medicine every month. Many doctors manage much more than this, so they actually still get a feel of real frontline medicine.

The worst possible option is to give up clinical practice completely when they expand their careers. Whether the aim is to progress within an institution or a separate entrepreneurial venture, doctors should keep being doctors. After all, it’s where they gained their knowledge and experience of health care in the first place. It’s also usually what they do best.

That’s my advice for any doctor faced with that dilemma right now. Being a doctor is a privilege and an honor. What about the patients that need you, the waiting families, the nurses with questions on how to make their patients feel better? It’s those one on one moments with patients and their families that make the job so special—the trust and special bond between doctor and patient is not reproducible in many other arenas, no matter how worthwhile the work may seem. In the midst of our busy and hectic days it is sometimes easy to forget the enormous responsibility that comes with being doctor. The job can seem never-ending and the to-do list can feel like the world on your shoulders. Often nothing short of super human effort is expected of you each and every day.

Back then to Dag Hammarskjöld. This particular piece of advice applies to any doctor wondering what is the most worthwhile thing to be doing. He said; “It is more noble to give yourself completely to one individual than to labor diligently for the salvation of the masses”. If there’s ever any question about what the higher cause is—striving to save the world or just being a good doctor—the answer is right there. It is always selflessly dedicating yourself to your patients.

Suneel Dhand, MD, ACP Member, is a practicing physician in Massachusetts. He has published numerous articles in clinical medicine, covering a wide range of specialty areas including; pulmonology, cardiology, endocrinology, hematology, and infectious disease. He has also authored chapters in the prestigious "5-Minute Clinical Consult" medical textbook. His other clinical interests include quality improvement, hospital safety, hospital utilization, and the use of technology in health care. This post originally appeared at his blog.

Labels: , , ,

0 Comments:

Post a Comment

Subscribe to Post Comments [Atom]

<< Home

Share

 

Contact ACP Internist

Send comments to ACP Internist staff at acpinternist@acponline.org.

Blog log

Members of the American College of Physicians contribute posts from their own sites to ACP Internistand ACP Hospitalist. Contributors include:

Albert Fuchs, MD
Albert Fuchs, MD, FACP, graduated from the University of California, Los Angeles School of Medicine, where he also did his internal medicine training. Certified by the American Board of Internal Medicine, Dr. Fuchs spent three years as a full-time faculty member at UCLA School of Medicine before opening his private practice in Beverly Hills in 2000.

And Thus, It Begins
Amanda Xi, ACP Medical Student Member, is a first-year medical student at the OUWB School of Medicine, charter class of 2015, in Rochester, Mich., from which she which chronicles her journey through medical training from day 1 of medical school.

Auscultation
Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital.

Zackary Berger
Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews.

Controversies in Hospital Infection Prevention
Run by three ACP Fellows, this blog ponders vexing issues in infection prevention and control, inside and outside the hospital. Daniel J Diekema, MD, FACP, practices infectious diseases, clinical microbiology, and hospital epidemiology in Iowa City, Iowa, splitting time between seeing patients with infectious diseases, diagnosing infections in the microbiology laboratory, and trying to prevent infections in the hospital. Michael B. Edmond, MD, FACP, is a hospital epidemiologist in Richmond, Va., with a focus on understanding why infections occur in the hospital and ways to prevent these infections, and sees patients in the inpatient and outpatient settings. Eli N. Perencevich, MD, ACP Member, is an infectious disease physician and epidemiologist in Iowa City, Iowa, who studies methods to halt the spread of resistant bacteria in our hospitals (including novel ways to get everyone to wash their hands).

db's Medical Rants
Robert M. Centor, MD, FACP, contributes short essays contemplating medicine and the health care system.

Suneel Dhand, MD, ACP Member
Suneel Dhand, MD, ACP Member, is a practicing physician in Massachusetts. He has published numerous articles in clinical medicine, covering a wide range of specialty areas including; pulmonology, cardiology, endocrinology, hematology, and infectious disease. He has also authored chapters in the prestigious "5-Minute Clinical Consult" medical textbook. His other clinical interests include quality improvement, hospital safety, hospital utilization, and the use of technology in health care.

DrDialogue
Juliet K. Mavromatis, MD, FACP, provides a conversation about health topics for patients and health professionals.

Dr. Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal medicine for more than a decade and is an Associate Professor of Medicine at an academic medical center on the East Coast. His time is split between teaching medical students and residents, and caring for patients.

Everything Health
Toni Brayer, MD, FACP, blogs about the rapid changes in science, medicine, health and healing in the 21st century.

FutureDocs
Vineet Arora, MD, FACP, is Associate Program Director for the Internal Medicine Residency and Assistant Dean of Scholarship & Discovery at the Pritzker School of Medicine for the University of Chicago. Her education and research focus is on resident duty hours, patient handoffs, medical professionalism, and quality of hospital care. She is also an academic hospitalist.

Glass Hospital
John H. Schumann, MD, FACP, provides transparency on the workings of medical practice and the complexities of hospital care, illuminates the emotional and cognitive aspects of caregiving and decision-making from the perspective of an active primary care physician, and offers behind-the-scenes portraits of hospital sanctums and the people who inhabit them.

Gut Check
Ryan Madanick, MD, ACP Member, is a gastroenterologist at the University of North Carolina School of Medicine, and the Program Director for the GI & Hepatology Fellowship Program. He specializes in diseases of the esophagus, with a strong interest in the diagnosis and treatment of patients who have difficult-to-manage esophageal problems such as refractory GERD, heartburn, and chest pain.

I'm dok
Mike Aref, MD, PhD, FACP, is an academic hospitalist with an interest in basic and clinical science and education, with interests in noninvasive monitoring and diagnostic testing using novel bedside imaging modalities, diagnostic reasoning, medical informatics, new medical education modalities, pre-code/code management, palliative care, patient-physician communication, quality improvement, and quantitative biomedical imaging.

Informatics Professor
William Hersh, MD, FACP, Professor and Chair, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, posts his thoughts on various topics related to biomedical and health informatics.

David Katz, MD
David L. Katz, MD, MPH, FACP, is an internationally renowned authority on nutrition, weight management, and the prevention of chronic disease, and an internationally recognized leader in integrative medicine and patient-centered care.

Just Oncology
Richard Just, MD, ACP Member, has 36 years in clinical practice of hematology and medical oncology. His blog is a joint publication with Gregg Masters, MPH.

KevinMD
Kevin Pho, MD, ACP Member, offers one of the Web's definitive sites for influential health commentary.

MD Whistleblower
Michael Kirsch, MD, FACP, addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.

Medical Lessons
Elaine Schattner, MD, FACP, shares her ideas on education, ethics in medicine, health care news and culture. Her views on medicine are informed by her past experiences in caring for patients, as a researcher in cancer immunology, and as a patient who's had breast cancer.

Mired in MedEd
Alexander M. Djuricich, MD, FACP, is the Associate Dean for Continuing Medical Education (CME), and a Program Director in Medicine-Pediatrics at the Indiana University School of Medicine in Indianapolis, where he blogs about medical education.

More Musings
Rob Lamberts, MD, ACP Member, a med-peds and general practice internist, returns with "volume 2" of his personal musings about medicine, life, armadillos and Sasquatch at More Musings (of a Distractible Kind).

Prescriptions
David M. Sack, MD, FACP, practices general gastroenterology at a small community hospital in Connecticut. His blog is a series of musings on medicine, medical care, the health care system and medical ethics, in no particular order.

Reflections of a Grady Doctor
Kimberly Manning, MD, FACP, reflects on the personal side of being a doctor in a community hospital in Atlanta.

The Blog of Paul Sufka
Paul Sufka, MD, ACP Member, is a board certified rheumatologist in St. Paul, Minn. He was a chief resident in internal medicine with the University of Minnesota and then completed his fellowship training in rheumatology in June 2011 at the University of Minnesota Department of Rheumatology. His interests include the use of technology in medicine.

Technology in (Medical) Education
Neil Mehta, MBBS, MS, FACP, is interested in use of technology in education, social media and networking, practice management and evidence-based medicine tools, personal information and knowledge management.

Peter A. Lipson, MD
Peter A. Lipson, MD, ACP Member, is a practicing internist and teaching physician in Southeast Michigan. The blog, which has been around in various forms since 2007, offers musings on the intersection of science, medicine, and culture.

Why is American Health Care So Expensive?
Janice Boughton, MD, FACP, practiced internal medicine for 20 years before adopting a career in hospital and primary care medicine as a locum tenens physician. She lives in Idaho when not traveling.

World's Best Site
Daniel Ginsberg, MD, FACP, is an internal medicine physician who has avidly applied computers to medicine since 1986, when he first wrote medically oriented computer programs. He is in practice in Tacoma, Washington.

Other blogs of note:

American Journal of Medicine
Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.

Clinical Correlations
A collaborative medical blog started by Neil Shapiro, MD, ACP Member, associate program director at New York University Medical Center's internal medicine residency program. Faculty, residents and students contribute case studies, mystery quizzes, news, commentary and more.

Interact MD
Michael Benjamin, MD, ACP member, doesn't accept industry money so he can create an independent, clinician-reviewed space on the Internet for physicians to report and comment on the medical news of the day.

PLoS Blog
The Public Library of Science's open access materials include a blog.

White Coat Rants
One of the most popular anonymous blogs written by an emergency room physician.

Powered by Blogger

RSS feed