I wonder if we're in danger of stifling fun in medicine.
Certainly there are still fun things to do in medicine (ablating a pesky accessory pathway safely, for instance). But as I watch the newly-minted medical school graduates emerge from their long, sheltered educational cocoon, I wonder what their attrition rate will be from medicine once they see our new more-robotic form of health care community.
There is a social camaraderie in medicine when you train. Maybe it's the "misery loves company" syndrome. In medical school you stick together through thick and thin because few others understand what you're going through. You strive for the day when, collectively, you earn the designation of "doctor of medicine." There's a strength in numbers.
But as our work flows become regimented, our geographic coverage areas more dispersed, and our hours more fragmented, I've seen the loss of the collegiality of the doctor's lounge being replaced with the coldness of e-mail blasts. I've seen the loss of summer picnics with my colleagues' families replaced with "Doctor Appreciation Day." After work get-togethers that included our spouses and kids are have long since gone - most of us just want to get back home to re-group for the next day ahead.
As medicine continues on its inevitable cost-contraction course of doing more with less, I hope there continues to be a way to keep the psychological well-being of our health care workforce and their families in mind. Otherwise, the historically long-term career of physicians might become much shorter.
-Wes
5 comments:
Wes -
Just want to say again how much I love your blog and what you choose to write about. You say what so many of us are thinking, sometimes even before we realize we are thinking it! You are truly the voice of the modern doc.
Thanks.
Peggy
Hi Wes,
I agree with you on this one; it's really important that health care teams get along and be supportive. Unfortunately, the stressed environment in some academic departments, especially among junior faculty competing for grants, publications, salaries and basic help like secretarial support, doesn't always promote a friendly or collegial environment. This, on top of long hours and heavy responsibilities, can lead to physician burn-out and lesser quality of care.
The military has fell victim to Political Correctness, sympathy sessions, boy-girl relationships, no cursing, getting drunk with your shipmates in Hong Kong, asking someone to do something they not like rather than just telling... Get fifteen years in and make a wrong move it might be a career breaker... rather than a stumble and get a second chance. I liked it the old way when we were sailors and shipmate and looked out for each other and had respect and pride... lots of tradition has gone by the way in favor of robotic behavior. No time for a little fun or libation... not acceptable in today's military... Even special forces are being eroded by fat cat politicians who have not sweated a day in their lives. Ahhh... all good things come to an end!
Part of what you describe is just the process of leaving school and entering larger life, which is more isolated and less spontaneous. This happens in all fields, and the dissapointment even occurs after leaving college (undergrad). Suddenly, you can't just gather the gang from down the hall and go out for ice cream...
The comraderie is especially strong in some academic cultures where the training is intense, like medicine, and in science, where we bonded (or fought) with labmates we trained with.
Medical care has also become a very gender prejudiced atmosphere. Far more males reprimanded for their disagreements with female hospital personnel, even when the rest of us are scratching our heads about what was offensive! Robotics is a good description of how government medicine will be. Our ability to individualize care will be lost in the one-size-fits-all approach that government has to take on everything. "Best Practices" can be followed by anyone, even when they are wrong!
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