Some physicians are happy -- and not afraid to say so

Commentary. By Dick Walt, amednews contributor. April 16, 2001.

COMMENTARY

Observations on the state of medical practice and medical life

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In the nearly 40 years that I've been involved with the medical profession in general and with a great many individual physicians, there have been many changes.

Most have been for the good. Certainly, the level of care provided to patients today far surpasses anything that might have been foreseen by all but the most visionary individuals back in the 1960s. The profession, too, has changed, bolstered by a level of diversity that few would have dreamed of four decades ago.

Despite the many advances, however, there has been one disturbing trend, particularly in more recent years: the growing number of physicians who publicly professed unhappiness with their lot in life. Too much government regulation; too much interference from the insurance companies; too much managed care; the entire litany of acronyms that are not a part of medical practice -- HMOs, PPOs, MCOs, PROs, HCFA -- all come in for a share of the blame.

A frequent complaint is, "Patients nowadays don't love their doctors like they used to a few years ago." And I have heard literally dozens of physicians say they would never advise their own son or daughter to enter the medical profession.

So I am prompted to write this by two isolated and unrelated events, which rekindled in my mind a hope that perhaps the pendulum actually has begun to swing -- or at least creep -- back in the other direction.

The first came while scanning a college alumni publication and noting a brief article about a physician who had made a contribution to his alma mater's medical school. An ophthalmologist in a small Midwestern town, he summed up his professional life like this: "It's been a very rewarding profession. I really enjoy the instant return of happy patients -- and they also pay you to do it. I'd do this for free." (Incidentally, one of his sons is a medical student.)

A few days later I was at a dinner table with a 50-something gastroenterologist from a medium-sized city in the Southeast. I had a chance to eavesdrop on a conversation between him and the mother of an 18-year-old who's just started undergraduate school. It went along these lines:

Doctor: "Your daughter just started college? What's she studying?"

Mom: "Pre-med."

Doctor: "That's terrific! Tell her to stick to it and not get discouraged or change her mind. It's worth every bit of the effort."

Mom: "I can't tell you how reassuring it is to hear you say that. It seems as if every doctor we talk to advises her against it."

Doctor: "Well, if she ever has any doubts, you just tell her to call me up. Medicine is a terrific career, and I can't imagine ever being happier or more satisfied doing anything else."

Of course, as Aristotle cautioned, "One swallow does not make a spring," and I'm not naïve enough to believe that these two anecdotes represent any sort of trend. Nevertheless, it is somehow reassuring to know that there are happy, satisfied physicians out there who are not afraid or embarrassed to say so.

It would serve future generations of patients well if other physicians took the time to offer encouragement to young people who might be considering following in their footsteps.

Walt served as editor of AMNews from 1982 to 1991.