How Do I Become A Great Doctor? How Do I Know What Kind Of Doctor I Want To Be?

This question was originally posted on Quora.com and was answered by David Chan, MD from UCLA, Stanford Oncology Fellowship

This is a question often asked by earnest medical students and interns over a meal or during a contemplative moment at the end of the day in the parking lot. It's not easily answered but I've had the conversation often enough that this is part of my answer to them.

I think that most of us who've been in medicine for awhile, nurses included,
recognize bad medicine when it happens. And we also know who the best doctors are.

The following qualities are characteristics that the best doctors exhibit:

1. Excellent fund of knowledge. There is no way to be great at anything without knowing what you're doing. Up To Date is only going to take you so far. There's no substitution for studying and knowing the material, reading journals and attending educational meetings and seminars to stay current.

2. Clinical judgement. Part of this is learning from experience and part of this is having common sense. That's right, common sense. After you diagnose the problem, often there are different solutions that offer themselves. What are the risks versus the benefits of what you think you should do?

Is this an emergency or is slow and careful a better approach? Is this 85 year old man well enough to undergo hip replacement surgery now or should he have a tune-up with his cardiologist first? Should this 35 year old mother of two with early stage breast cancer get chemotherapy for a 2 percent improvement in a cure rate that is already 90-95 percent or avoid the potential toxicities?

3. Commitment. The patient comes first. Always. The sick patient seeing you at 6 pm doesn't care about your kid's piano recital, your tickets to a concert, or friends you are supposed to meet for dinner tonight. This patient and their family are counting on you to do your best. No short cuts to get out on time. If you've absolutely got to be somewhere, don't put yourself in a position where it might not happen.

I've seen doctors rushing through something to catch a plane. That's absolutely wrong. Medicine should be a calling and not a job. If it's a job, your patients should be seeing someone else.

4. Advocating for the patient. If you are the doctor, you are the patient's health advocate. That means that whatever you do, you're doing it in the patient's best interest. That means that you put the patient's well being first, ahead of your own wants and needs, ahead of physician friends and colleagues, and ahead of the preferences of your employer.

You only do the operation or perform the procedure because it's in the patient's best interest, not because you'll be paid or need the case to keep your numbers up.

If you know that you can't do the case, you send the patient to someone more qualified. You don't refer a patient to another doctor just because she's your good friend if you know that someone else can do it better.

If you wouldn't send your sister there, then why are you sending your patient?

5. Treat the patient like you would want your doctor to treat you. That means showing compassion, understanding, and giving explanations in plain language that they can understand. And repeating it again until it's understood. If you don't want to see a doctor with one foot out the door, speaking the equivalent of a foreign language, while texting on an Iphone, then don't be that kind of doctor either.

This is also a part of the answer to why medical school should never become a trade school that allows anyone and everyone that wants to practice medicine to just pay the tuition and go to it. I don't think that any of us want to be cared for by an average physician, let alone someone even less than that.



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