Judging from recent articles, surveys, and blog posts, the medical profession is remarkably demoralized. Typical complaints range from “feeling like a beaten dog” to “living in humiliating servitude,” to being forced to practice “treadmill medicine.” Interestingly, the public response to these complaints is largely indifferent. The prevailing attitude (if the “comments sections” of online articles and blog posts are representative) seems to be unsympathetic: “Poor doctors, making a little less income and not being treated like gods anymore? You have to do extra paperwork? You have to work long hours? Welcome to the real world, you whiners!”
But thank goodness that practicing medicine is more nuanced than the Facebook stream of hostility that we are subjected to on a daily basis. If patients spoke to me the way online comments read, I’d surely have quit medicine years ago. But my reality is that patients are generally grateful, attentive, and respectful. This could be because I work in inpatient rehabilitation medicine, a place where patients are screened for motivation to participate in their care, but I don’t think that’s the whole story. I have experience working in other settings across the country (including Emergency Departments), and I have found a significant number of good-natured, engaged patients there too.
I think that to some degree our attitudes shape our work environments. Patient and peer dispositions are in part a reflection of our own. Try approaching a frightened, sick patient with an arrogant, dismissive tone and see how your professional relationship with them (and their families) develops. There is a negative cascade that physicians can trigger (perhaps unwittingly) when they are rushed, curt, or inattentive. Beginning every new patient relationship with a caring, respectful, detailed history and physical exam lays a foundation of trust for future interactions. Once you have established that positive rapport, the daily grind (along with what my friend, Dr. Steve Simmons, has nicknamed ‘C.R.A.P.P.’ – Continuous Restrictive And Punitive Paperwork) is much more bearable.
As physicians we have the power to make our careers as meaningful or soul-sucking as we choose. Reducing the C.R.A.P.P. in our work lives can help (I’ve tried outpatient, “concierge style” practices and inpatient locum tenens assignments with good success), but that’s not the most important factor in enhancing work satisfaction. The relationships built by allying ourselves with patients, and shepherding them through this broken system, are where the rewards lie. They hold the keys to our professional fulfillment because nothing can beat the joy of helping those in need.
How do I know that patient appreciation is enough to make medicine worthwhile?
Because I still don’t hate being a doctor.