|Chicken or Eagle?
Image by Wes Fisher MD
(Click to enlarge)
In a 2018 survey conducted by Merritt-Hawkins, 78 percent of physicians said they experience some symptoms of professional burnout. Physician burnout is a public health crisis which threatens the health and well-being of all patients.
A burned-out physician reminds us of the fable about an eagle who believed he was a chicken.
When the eagle was small, he fell from his nest. A chicken farmer found the eagle, brought him to his farm, and raised him in the chicken coop with his chickens. The eagle grew up living like a chicken, doing what chickens do, and believing he was, indeed, a chicken.
One day, a visitor came to the farm and was surprised to see an eagle --considered the king of the sky-- strutting around the chicken coop, pecking at the ground, and acting like a chicken. The farmer explained that this bird was no longer an eagle, instead he was a chicken because he was trained to be a chicken. The man knew there was more to this great bird than “pretending” to be a chicken. He was born an eagle and had the heart of an eagle, and nothing could change that. The man lifted the eagle onto the fence surrounding the chicken coop and said, “Thou art an eagle. Stretch thy wings and fly.” The eagle looked at the man and glanced down at his home among the chickens in the chicken coop where he was comfortable. He jumped down off the fence and did what chickens do.
The farmer shrugged and said, “I told you he is a chicken.” The visitor returned the following day and tried again to convince the farmer and the eagle that he was not a chicken. He took the eagle to the top of the farmhouse and said: “Thou art an eagle. You belong to the sky and not to the earth. Stretch your wings and fly.” The large bird looked at the man and then glanced down at the chicken coop. He jumped onto the roof of the farmhouse and returned to the place where he felt safest.
The visitor asked the farmer to let him try one last time.
The next morning, the visitor returned and took the eagle and the farmer to the foot of a high mountain. They could not see the farm nor the chicken coop from this new place. The man held the eagle on his arm and pointed into the sky where the bright sun beckoned and said: “Thou art an eagle! You belong to the sky and not to the earth. Stretch your wings and fly.” This time the eagle stared skyward into the bright sun, straightened his body, and stretched his powerful wings. His wings moved, slowly at first, then surely and confidently. With the mighty screech of an eagle, he flew.
Because he was an eagle.
This past December 2018, four brave internal medicine physicians --recognizing they are eagles-- filed a lawsuit against the American Board of Internal Medicine, the largest ABMS member board, for harm they endured from the Maintenance of Certification process. Practicing Physicians of America has set up a fund to support our colleagues who are fighting this battle and need the support of fellow physicians.
Merely 1324 physicians, out of 800,000 in the US, have contributed to the legal fight against the onerous MOC process, despite the fact that it is reviled by the majority of doctors. Physicians members of the American Board of Radiology and the American Board of Physical Medicine and Rehabilitation have filed lawsuits of their own regarding violation of anti-trust laws.
Why are so few of our fellow physicians standing up when given the chance?
Unfortunately, physicians often choose consistency over happiness. If you’re used to being abused, ignored, or exploited, it’s strangely comforting to remain in the chicken coop and peck at the ground. These physicians are just like the eagle who believed he was a chicken.
Maybe physicians prefer the devil they know to the devil they don’t know. Maybe physicians are terribly uncomfortable at the prospect of failure. Maybe physicians believe it is better to control failure than be blindsided by it. Physicians are standing on the mountain and being asked to spread their wings and fly. What is stopping us?
The possibilities for the future of our profession are endless if we can win against the American Board of Internal Medicine. If there were ever a time to join the fight, it is now. Surely $100, $200 or even $500 is not too much to contribute to support our talented physician colleagues who have been harmed by MOC.
Now we are asking every physician in America, are you a chicken or are you an eagle?
- Niran Al-Agba, MD and Westby G. Fisher, MD
Drs Niran and Fisher and unpaid board members of Practicing Physicians of America.