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I See A Lot Of Hippocratic Hypocrisy When I Look Around Medicine

Discussion in 'Hospital' started by The Good Doctor, May 14, 2021.

  1. The Good Doctor

    The Good Doctor Golden Member

    Aug 12, 2020
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    An excerpt from The Physician Assistant Blueprint.

    Unsolicited opinion warning: I see a lot of Hippocratic hypocrisy when I look around medicine. During our training and careers, we are laser-focused on the clinical skills needed for a career of “doing no harm” to those we care for, yet we never had to pledge to give the same to ourselves, nor did the system-at-large have to do so. Our altruism and efforts are honorable, but the current state of health care worker well-being tells me that we may need to take some of our own medicine.

    Sadly, many of us are walking around feeling burned out, underpaid, unable to pay off our student loans, losing hundreds of thousands of dollars on retirement investing, and generally feeling unfulfilled. One of the main reasons is that our medical system doesn’t simultaneously develop our clinical and career skills, leaving us to naively figure out the latter. During our didactic and clinical educations, we are so focused on learning our trade that we fail to learn about what it takes to have a prosperous and fulfilling career.


    It seems that there is not enough time within a compact curriculum to integrate in lectures about critical aspects of our career. For argument’s sake, let just agree that that is true, making the next opportunity to learn about these career facets once you start your clinical experiences. My question is: Have you had the experience of a teacher, preceptor, mentor, or supervisor taking the time to give you solid career training? Most likely, your answer is no, and that is one of many opportunities lost.

    Maybe our clinical training time is not optimal to learn about and absorb information on compensation plans, 401(k) investment options, continuing medical education (CME), burnout prevention, or any of these things. Perhaps our mental bandwidth doesn’t allow for concurrent learning of clinical and career skills, and we just need to focus on getting to day one of our new careers and then will figure it out. Our employer will be there to act as our financial and well-being fiduciary, guiding us onto the optimal career path, right? Well, maybe not.

    Tell me if this sounds familiar:

    You’re excited and anxious about starting your new job, and your new employer sets up a whirlwind of an orientation. You are introduced to your new colleagues, meet with HR, sign a mountain of paperwork, and then get set up at your new workplace. During these hectic first few days, you’re so focused on getting to day one that you can’t even recall what health insurance plan you signed up for, which 401(k) plan you chose, the details of your compensation plan, or which resources you have for burnout. All you have to show from your orientation is that folder brimming with paperwork and flyers, much of which is impossible to decipher. You were told that you can always change the selections that you’ve made once per year during open enrollment. So, between the ability to do that and those optional meetings with the Fidelity representative, you convince yourself that you’ll be able to figure out these complex issues, but just after you start.

    Then comes day one, and you realize that being in the medical field is quite demanding. The tasks are complex, the consequences of making a mistake dire, and support not as present as you hoped for. Within those first formative years of your career, the learning curve is steep and commands most of your attention. The months and years pass, with each open enrollment coming and going, your financial advisor telling you to stay the course, and that life-work balance not quite where you want it. Nonetheless, you soldier on and vow to figure out how to forge your best path forward.

    Perhaps you decide that you deserve a raise but yet don’t know the optimal way to do this? Or, perhaps you get inspired to better understand your 401(k) but get so overwhelmed by the details that you decide to stay on the subpar course that you’re already on. Or, perhaps you want to take control of the burnout setting in but don’t know strategies to start the healing process? If any of this sounds familiar, then you’re not alone and need to understand that much of this is not your fault or evidence of your inability to hack it.

    How can we be expected to thrive in our careers if most of us do not even receive training on critical aspects of our career foundation? What saddens me is that our ignorance of professional training is causing us harm. The burnout epidemic evidences this, huge chunks of retirement savings being siphoned away by predatory practices, crippling loan debt, and health care workers feeling disenfranchised.

    The good news is that there is a way to forge a better career path. There are many things that you can and should be doing on your own, which can serve to empower you to live your best life. But the onus of responsibility is not just on us as individuals and should be shared with our medical institutions. We need more educational and health care institutions making career training a priority, taking actions to standardize and improve upon this. Fortunately, some well-renowned public and private establishments are helping us move the needle towards better well-being for medical professionals.

    I’d like to see a more pragmatic approach to career development, with practical and meaningful actions being taken to relieve the burden of harm being done to us caregivers. I’d like to see more institutions swearing to fulfill, to the best of their ability and judgment, with “warmth, sympathy and understanding,” a pledge to improve the lives of medical professionals for us to “enjoy life and art” as we so deserve. And in doing so, may these institutions “experience the joy of healing those who seek their help.”

    Shayne Foley and Jordan Fisher are physician assistants and authors of The Physician Assistant Blueprint.


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