With all the negative press, the pay cuts, the uncertainty of health care reform, I am approached by people who secretly whisper in my ear, "Would you have your child go in to medicine?"
On first blush, I am tempted to answer "Heck no!" given the administrative hassles, the changes in the public's perception of our profession, the front-load of education and the long hours involved. But those observations, while real, are at best superficial. Drilling down with more careful analysis after a challenging weekend on call, I find it worthwhile to stop and ask myself what makes medicine special for those of us crazy enough to subject ourselves to this lifestyle. I decided to put together a list of things that were important to me and would welcome additions to the list from others.
10. Independence - No matter what happens on the larger public policy and procedure scale with guidelines and mandates, when it comes to decisions regarding a patient's care, it will always be the one-on-one interaction between the patient and the doctor that will ultimately decide the best approach for care for an individual patient.
9. Respect - The title "Doctor of Medicine" still carries weight in our society. With that respect, however, comes significant moral imperatives to maintain that respect.
8. Flexibility - For those not adept at one-to-one interactions with people (hence, the clinical side of medicine), there are a myriad of opportunities opened with the MD or DO degree in public policy, research, the basic sciences, journalism, consulting, business, etc. It is this flexibility of options that are open to doctors that ensures job security.
7. Variety - I have been doing medicine a long time and have yet to see two days' activities or two patients that are the same. Ever. Bottom line: medicine is never boring.
6. Influence - Physicians matter. People know it. But you'd better be ready to be cornered at cocktail parties.
5. Reward - I cannot not think of anything superior to helping a fellow man or woman at a time when they are most vulnerable or in the greatest need. It also occassionally provides upgrades to first class when you help treat a syncopal patient on an airplane.
4. Trust - Like Smith Barney says, you have to "earn it," but once a patient's trust and confidence, it's the tie that binds. By virtue of your title, you are invited into the most secret parts of patients' lives to share their deepest concerns - a truly remarkable privilege. Corporate meetings never leave me with that feeling, if you get my drift.
3. Humility - Medicine will always keep you humble since there will never be a time when you can know it all or cure it all - ever. It's both the blessing and the curse of our profession: the learning never ends.
2. Fascination - Every day we work with the most amazing technology imaginable. The wonder of it all never ends: ask anyone who's ever reached in an abdomen to remove ischemic bowel, prescribed an antibiotic to cure a pneumonia, or ablated an tachycardia that affected someone their entire life and rendered it of historic interest only. Even something as simple as cutting the skin with the belly of a 15-blade scalpel while listening to the patient chat idly about their grandkids thanks to remarkable local anesthetics during a pacemaker implant, you are reminded of the amazing wonders of modern medicine every day.
1. Teamwork - Medicine is, by definition, a team sport. No physician can do what we do in isolation. Our "Club Med" has challenging pre-requisites, but once in, it is a vocation where we share collectively in the trials and tribulations of patient care. We win and we lose, together. Whether we are doctors, nurses, technicians, administrators, clerical staff, safety personnel or maintenance workers - each of us are constantly working for a common goal - the health and well-being of our patients - and when it works, nothing, I mean nothing, is as cool as that.
Thank you for this. My 2nd child was born with a CHD. So far we've had 3 OHS and a pacemaker implanted. Both my girls it seems were raised in hospitals and doctor's offices and they often play doctor at home ALL the time. (Not just doctor, "heart surgery" :-) My oldest continually wants to be a doctor, has since she's been 4. And even though she's only in elementary school, it's clear she has the intelligence and drive for it. These last few years I continually look at her, admire her determination, but secretly wonder "Do I even WANT her to be a doctor???" Your post was wonderful, but how sad a time are we in when parents are actually hoping their children WON'T be doctors? Scary, very scary!
This is not for posting but question for you. I could not find your email on the site.
Thanks for your wonderful posts. I have question - Should female cardiac interventionalists esp doing PCI stop doing procedures when pregnant? Is there any data on this and pregnancy related complications? Thanks. RR. RRoyala@gmail.com
Knowing what I do now, I would do it all over again. For sure.
Except in college, I would have taken more humanities, and less science, so as to have become a smarter blog author.
number 11: Free lunch every day for the rest of your life
Love the post and your blog! Good for you that you see the positives about being a physician when so many are seeing negatives. Way to go doc!
I'm from Malaysia..tanks for wonderful post..next week i will enroll for colleague..i dunno if i can be a doctor..but if im not meant for this job..i will end up become a volunteer for charity at hospital..this post give me some 'spiritual bomb',,tankz a lot...and i do agree that medicine is never boring...!
As a third year med student, I'd like to add "Fun!" to your list. It's an adrenaline rush at times and the most funny stories I have in my 30 years of life are from medicine. As a good friend said, I get paid to have fun!
Thanks for a terrific post! I'm new to you but saw a mention in the WSJ Health blog.
If I may add my own #11, I think "being able to tell awesome stories at cocktail parties". I'm starting my surgery residency in July, and I already have some wonderful memories of the crazy things I saw while showcasing this past year. I may not end my career as the wealthy doctor of yester-year, but I am sure that I will still be able to say I led a rich life.
PS - Thanks for the DO recognition!
Having survived cardiac arrest, and now sporting an AICD, I am celebrating my "re-birth" 4 years on!
So, no matter how bad it gets here "above ground," because I am awake and ambulatory, I am forever thankful for EMTs and doctors like you! Especially when I tee off every other week! johnrio
The "human side" of medicine is what keeps us all going. The subjective nature of assessing an individual patient by putting everything together is an art that cannot be replaced by any fancy million dollar diagnostic equipment. This cognitive process cannot be replaced by any computer algorithm. Human patient will always be seen by "human" doctor. No machine will replace us.
My name is Oscar Heredia, I am a medical student Chileno. I'm just starting the race, just recently finished my second year and every day I feel more satisfied to have decided to study medicine. Reading his blog, I found very interesting this post, I think I agree with many of these reasons. I think they should incorporate the "vocation" for medicine. Personally I think it is essential to choosing a career in the health area or any area of study. I appreciate the opportunity to reflect on the reasons that motivated me to enter the world of health and care of people who need the support of a medical team.
My name is Daniela Guerrero, I'm from Chile and I'm a second year medicine student. I want to congratulate you for your brilliant and refreshing posts. I have been following you for a while now and I find your blog very interesting and informative.
This post is particularly inspiring for me. I'm a PSVT patient, and that was my very first reason to get into medical school, to someday be able to help others like me.
But even while I'm still in training to be a doctor, I'm feeling identified with the reasons you give in this post.
Reward, humility, fascination... That's what this is really about, help others and marvel at the miracle of life. Medicine it's an AMAZING CAREER, to be a medicine student requires sacrifice but all the effort along the way worth.
Thank you Dr. Wes for sharing your thoughts and for remind me and all who read your blog why we are doing this.
Good post! I especially like it because like ya said, it's never boring. Couldn't see myself doing anything else.
wonderful post. there are many reasons to be a doctor, and i think you've hit the nail on the head by identifying so many key points.
Doc, thanks. That's all I've got to say. :)
Why do you choose to be a cardiologist? What's your motivation?
I'm a pre-medical student in college. There is a ton of negative press out there, and it's hard not to let it get to me and make me question medicine as an occupation. I constantly hear stories of 60+ hour weeks and mounting debt, and even my family is questioning my decision to be a doctor.
My question to you, then, is how did you decide that you could handle it?
With Thanks and Respect,
Dear Dr. Wes ... I stumbled onto your web page by clicking on the wrong link I had saved for reading later. One word - thanks!
I am a fully trained physician who migrated to the United States. I cleared all my board exams but with limited seats for getting into residency at that time - I was unable to. Tried about seven years and gave up. Focused on non-clinical medical research. Sometimes I ask what is it that I am missing - the feeling of loss on viewing facebook old friends who are surgeons and gyn docs now.
You answered it though for me ... it was the respect and trust.
Thanks for a nice post.
I am glad I became a doctor.
I am proud of my son who is a first year medical student.
I think your list got gutted a little bit with health care reform. But the fact that you would list 'humility' is one reason I enjoy looking at your blog. That's very rare. What I have seen medical students taught is perfected hubris to project confidence even whilst totally blowing smoke out of one's tushy, having no clue whatever what to do but being good at lying about it. You are what a doctor is SUPPOSED to be. I am pleased that you would reproduce after your own kind and be teaching. Your character shines through, even more so that your skills and expertise.
I like your mention of "significant moral imperatives to maintain that respect," which too many others see as an ENTITLEMENT. Imagine, people who still consider respect to be an earned reward? I have seen people go into medicine for that status and respect, knowing that as complete lowlife, it would take the title of "Doctor" to somehow impart a dignity to them that they could otherwise not attain.
There are actually a lot of evil parasites in medicine. You know the ones, they read the stock portfolio more often than a medical journals--because that's what really matters the most to them. The bill is due regardless of whether the patient drops dead. But you don't want patients dropping dead: a really good reason to be a doctor.
Who knows if one day I could meet you in person, maybe you would be an abrasive pompous ass, it could happen. I think it wouldn't but am no longer surprised at anything. But at least on the internet you are a really good guy, someone whom God made a Doctor. Thanks, Lisa30092
Good heavens. All of these reasons are about the doctor, not the patient. My number one reason for being a dentist is that I get to directly help people live better lives. All of those other enumerated points are valid, but they are secondary benefits. This is a service profession, and the passion to serve should be at the top of the list.
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