This year, 2016, has been a challenging year for physicians and the “professional
services” that they are trained to provide. In addition, the year
has put into question the sincerity that many physicians have demonstrated
when they took the Hippocratic Oath at graduation which mandates that
whenever they are treating patients, above all, their care should “do
Early in 2016, a governmental report indicated that medical errors are
now the third leading cause of death in the United States, falling closely
behind heart disease and cancer. Several months ago, the Physician Foundation
reported that, based on a survey of over 17,000 physicians, over 50% are
dissatisfied and unhappy with their work, causing many older physicians
to retire earlier than planned. And finally, in a Medscape Medical News
article by Robert Lowes published December 1, 2016, the author indicated
“more physicians are willing to hide mistakes”. He reported
survey results which indicated that 7% of physicians say it is acceptable
to hide a clinical mistake that harms patients while another 14% leave
the door open, saying it depends on the specific circumstances.
What does all of this mean? Fortunately, on the positive side, the data
indicates that nearly 75% of all physicians are striving to do what is
right for the patient, providing the highest quality of medicine possible
and abiding by the highest ethical and moral standards that healthcare
demands. But the reality is that the data also highlights the extreme
variability in medical outcomes across the profession and supports the
message I have been spreading for over the last decade…there is
“no common voice” representing the medical profession. And
like all other services that demonstrate extreme variability, the work
of the higher performers is diminished, and often cancelled by the lower
ones. Undoubtedly, once again, the “physician chain” is only
as strong as its weakest link.
So what are some steps that can be taken by physicians, both young and
old, to make 2017 a better year for the entire profession, both internally
as a group, and externally to the various constituents that physicians
have the honor to serve? These should, at the minimum, include:
Commit to the mandate in the Hippocratic Oath to never intentionally do
harm. This requires that physicians are always aware of “what they
do not know”, and to always ask for help when they are facing cases
that puzzle them.
Commit to always doing what is right, and never considering the possibility
of losing one’s moral compass.
Participate actively in the staff meetings of their practices, medical
groups, and the hospitals to which they are affiliated. These meetings
offer a chance to discuss the potential solutions that would work to address
the challenges that are creating the high level of professional dissatisfaction.
Participate in continuing medical education sessions/meetings with peers
so that physicians have a clear sense if what is happening on a broader
scale. Also, such exposure helps to identify best practices of others
that hopefully can be transported into less effective work environments.
Being a physician, as I have now been for nearly 50 years, it is an honor
and a privilege as well as an awesome responsibility. People trust us
enough to turn their most precious possession over to us…their
life or a life of a loved one. This trust cannot be weakened by physicians
who knowingly are providing less than the highest quality of medical care,
who are willing to hide their mistakes, and who are daily dissatisfied
with their working environment. Until these challenges are addressed and
resolved, there will continue to be days, unfortunately, when I will be
embarrassed to say that I am a physician!