In medical school, we are not just taught the scientific information that doctors should know, we are also taught how doctors should look and behave. I remember being shown a video on “professionalism” during our first day of orientation. It was meant to be humorous, demonstrating more extreme examples of dress code and behavioral violations. Medical students walk into exam rooms with their bra straps hanging out. Smacking on gum and blowing bubbles during a patient visit. Speaking in a valley girl accent with every other word being “like.” The examples themselves were over the top and cringeworthy, but the message was more subtle and implicit. There is a right way and a wrong way to be a doctor. There is an expected code of conduct both for behavior and appearance. There are words you are not supposed to say. There are outfits that are not appropriate to wear. There are conversations you aren’t allowed to have. There is a certain bedside manner you must maintain. When you become a doctor, you are playing a certain role in society. You must have all the answers. You must be kind, empathic, and understanding at all times. You must be devoid of any aspects of your personality that are not universally likable or agreeable (especially if you are a female, person of color, or other minority). On the surface, these may seem like a reasonable set of commandments for how a doctor should behave. And on some level, I acknowledge there is merit to having a set of agreements made between doctors and society. As a doctor, you are representing a whole field of people. A patient’s interactions with you can color their perceptions of “doctors” as a whole. From a PR standpoint and a large organizational standpoint, perceptions matter. But what also matters is how putting on this “mask of professionalism” impacts doctors on an individual level. I remember from my own experience working in medicine, I felt like I was constantly calibrating myself to the role of “doctor.” Pausing before I walked into a patient’s room to summon up the qualities and persona associated with my white coat. I always felt on edge, like I couldn’t fully relax and be myself. I’ve heard similar stories from my physician clients, talking about how they wish they could joke around and let loose with their patients but aren’t sure if that’s acceptable. They want to wear a ridiculously frilly pink top or dye their hair purple but worry that it’s not appropriate. They want to be real and level with their patients, but instead, just say the scripted thing that a doctor is supposed to say. They feel stifled. Muted. None of these instances may seem very consequential. Who cares if you don’t get to wear the clothes you want or say whatever comes to your mind? But, I’ve come to realize that it all adds up. Each of these moments where we abandon what is real and true for us in favor of what’s expected of us is a subtle breach of our own personal integrity. It takes energy to repeatedly calibrate your true self into someone you are not. To constantly worry about maintaining appearances. It’s not just my own anecdotal experience. There are countless psychological studies detailing the impact of white lies on our physical, emotional, and relational health. According to a science of honesty study conducted by Dr. Anita Kelly, participants who told fewer white lies had fewer mental health problems (including feelings of tension and melancholy), fewer physical health problems, and reported improvements in their closer personal relationships and social interactions. Being inauthentic is a version of a white lie. A patient asks, “How are you doing?” Our authentic self wants to sigh and say, “You know what? I’m really tired today.” But instead, we put on the mask of professionalism, plaster on a smile, and say, “Great, how are you?” We don’t feel like we have permission to be our authentic, imperfect selves at work because we have to be who a doctor is supposed to be. And it’s exhausting. I won’t pretend to have the solution as to how to solve this problem. I don’t know the best answer, or if there even is one single best answer. But I know that putting on the mask of professionalism day in and day out drains your energy over time. Sacrificing your authenticity to play the role of “doctor” is a real cause of burnout. Sometimes just having that language to understand your problem is a good enough place to start. Source
