Dear Good Doctors, The main qualities attributed to, or anticipated from, a good doctor are being gifted with qualities that allow gaining sound knowledge and competent skills to provide safe comfort to patients while keeping good rapport with all around him. Many of the qualities documented so far are not only superhuman but also some are so conflicting that it is hard to be realistically implemented. Furthermore, no true doctor can have all the qualities at all times and circumstances in order to gain the “good” pass from all people of different walks of life. Surprising popularity may be attained by smooth talkers, few are humorously benign sparkling dull medical day and the odd one may get away with murder but the discussion here concerns the seriously good inside out. Good surgeons are good doctors with some extras, a case that requires special explanation. The nature of their training and job makes them chronically short of time (T), communication and social skills. So, if it is hard for genuine physician to be good doctor, it is nearly impossible for surgeon to be one. However, many do it without having divine power, magic lamp or even enough of the most basic requirement- T. This is demonstrable by the fact that only 3 of 43 contributions to this discourse so far are made by surgeons. The majority just get on with the job. Surgeons make up in self confidence and work for what they lack in patience, T and talk. Patients consider surgeons to be good doctors when they feel comfortable, safe and human with them. However, given the choice, they select the one who correctly diagnose their illness, cure it with safe procedure based on long track record of success and unblemished reputation. Surgeons treat people with knives and dangerous instruments and hence get more frequently sued than any other doctors. The difference between assault and therapy or complication and inflicted body harm as result of error, neglect or ignorance is frequently decided in Court, or in some places violent revenge against the surgeon or his family. Surgeons are also more involved in conveying bad news in such a short T that deprives them the leisurely discussions about therapy’s detailed pros and cons and all the foreseeable complications of planned or emergency procedure. Some patients, relative or co-workers may hate surgeons for denying excess T they do not have. My objective here is not to repeat the qualities that make a good doctor but to add other specially needed requirements for making a good surgeon, and above all present it in such reproducible manner to be useful to students and juniors in their future careers. Good Surgeon needs to learn how to operate, when to operate and when not to operate. He must also master the essence of many professions in addition to having Clock’s accuracy and Computer’s memory: Scientist’s knowledge, Investigator’s curiosity, Engineer’s precision, Craftsman’s art, Observer’s vision, Historian’s embodiment, Philosopher’s wisdom, Goldsmith’s honesty, Detective’s suspicion, Lawyer’s reckoning, Judge’s fairness, Pilot’s decision making, Clairvoyant’s telepathy, Diplomat’s tactfulness, endurance of long distance Lorry Driver, communication skills of TV Presenter, serenity of true believer and sociability of generous Host. Easy, isn’t it? Surgeons do the difficult everyday but the impossible takes longer. Time is the problem. There never enough T neither to gain such qualities during training nor implement in the reality of daily practice. Furthermore, advertising genuine good qualities is not allowed but some business and fakes ignore both the restriction and honesty. This may sound bad news deterring new comers. However, before switching career into more money making one if you truly have the qualities or to an easier job if you don’t, consider the deciding factor. It is the job you love doing while enjoying the privilege of being needed and useful to people, alleviating misery or pain, saving lives and contributing to the betterment of society. Can it be done, and how? The answer is easier said but the good news is ‘Yes’. Many good surgeons practice without ever having T or ability to explain how they do it. Much is learned by observing such good, and bad, ones around you but more is gained by careful reading and experience. The following observations may make it possible and easier for new comers. Be yourself and behave it. Do your best but know your limits. Get on with the job at hand within the given time freeing your mind and heart from all else while treating patient, colleague, wife or coworker as Special T Guest Star at your own home. Learn instant stance/problem assessment and solving. Develop decision making algorithm on “Priority Triage and Gear Selectivity”. Each gear is suitable for a specific job, occasion and person(s). Selecting the right gear for a specific job displays the qualities of good doctor but the wrong, misused or misplaced gear gives the opposite. Presenting in scientific meeting, writing to Journals or teaching students is conveying knowledge and experience of good doctoring but using the same in wrong circumstances or with aloof audience may be considered rude, self-advertising and arrogance. Be neither sheep nor show off superior knowledge to your boss. Respect seniority experience that can see through you, using own algorithm that sorts fake from genuine. S/he would appreciate and consider it to your advantage knowing when and where to disagree or pass on a new piece of information. As our business is service provider consider customers always right but never plan on winning all patients, people and battles, otherwise you may loose yourself while nobody gains nothing. Losing some battles or people on short term might be a worthwhile investment on longer term. The objective is to do no harm to oneself, patient or others but do not try to impress or please all. Do your dither calculations mentally and convey sharp decisions to patients softly, reassuringly and consistently with regular audit. Talk softly to patients and people in a language they can understand and listen to them but do not make promises you can’t keep. Decline with a smile any unreasonable or impossible request or demand. Document all facts and serious complications and get signed consent accordingly. People overcome the upset of hearing bad news conveyed with empathy but never forget if you mislead them or underestimate their intelligence or seriousness of their condition. Bad news is devastating to many patients, so explore what should be said with a sensible relative first. A problem with our World is that the knowledgeable is full of doubt while the ignorant is full of confidence. The solution is to think/document as professional and talk/reassure as politician. Also remember that the powerful has weakness and the weak has power but neither is aware of the other’s assets, and the best security is acting fair. Trust God to look after the things you can’t insure or control. Do not you worry about how good you are, or even your next job, people will give you what you truly deserve, and they would never ever declare Good as bad. Source
