Professional training and development are critical. Police officers, educators, orthodontists, painters, chief executives, musicians and chefs all need ongoing training to remain current. Job requirements evolve, and we must adapt. An accountant who hasn't kept up with new or anticipated tax law changes might not account for much when computing your tax obligation or refund.
Physicians need to be dedicated to ongoing professional development as much as any other occupation. Patients often wonder if their doctor is up to date. Does your primary care physician know about new medications for your condition? Does your orthopedist use the latest medical hardware when replacing your hip joint? Is your anesthesiologist using the same old laughing gas to put you asleep? Is your dermatologist's knowledge of his field only skin deep?
In the medical profession, there has been a paradoxical emphasis on reducing professional training. Here's what I mean. In hospitals, it is no longer true that every patient relies upon a registered nurse, or R.N., for nursing care. Now, lower level personnel such as nurse's aides and other care assistants are frequently utilized. I'll let the reader surmise what motivated this hospital “reform”. Nurse practitioners now roam the hospital wards, technically under the authority of a physician who is seeing his own patients in an office miles away. Why see your own primary care physician, when the “minute clinic” on the street corner is open for business. These clinics are conveniently housed in pharmacies so that any antibiotics prescribed, which we hope and pray are truly necessary, can be purchased on site.
Who should be doing your colonoscopy? Do you prefer a trained gastroenterologist, or would you be satisfied with a nurse who has been trained in how to technically use the instrument, as some cost cutters have advocated? Even a casual reader might appreciate that competency in a colonoscopy, heart catheterization or knee arthroscopy extends far beyond the technical requirements of the procedures.
Gastroenterologists are similar to Navy SEALS. We both train to a knife's edge and do all that we can to stay razor sharp. To my patients, I want to reassure you that staying current in colonoscopy is my life's mission. The training manual “Colonoscopy for Dummies” is never out of reach. Feel better?
This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who 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.