The landscape of medical practice has changed dramatically over the many decades I have been in practice. Most of these changes are intensely discouraging and depressing and are negatively affecting the physicians of today. The government, hospitals, networks, even our own professional organizations are working to establish and enforce new regulations — new hoops for doctors to jump through, mainly in the furtherance of their profit and their power over us. We must fight this stifling trend with every fiber of our being and stand up for the noble, uplifting profession we joined. Try as they might, they cannot destroy the very essence of what we do. In countless individual visits, we heal our patients’ bodies, minds, emotions and souls. This vocation is worth enduring the malicious influences of these “third-party” meddlers. I wrote the following essay some years ago, but I find my feelings are even stronger today. To be a doctor I guess I always wanted to be a doctor. Perhaps briefly a fireman (my grandfather and uncle were); occasionally a policeman (my two uncles were); never a cowboy or a pirate. But persistently and unequivocally, my dream was to become a doctor — not just any kind of doctor, a family doctor. While my medical school classmates were seduced by the glamor, prestige, decisiveness, and ego of the various specialties, I never changed my goal. Sure, the medical school professors (all specialists) tried to beat (browbeat) it out of me with derogatory comments about “LMDs” (Local Medical Doctors). There were many comments about the homes, automobiles and lifestyles of various GPs and what it can tell you about them. These professors extolled the advantages of wealth and how easy it was to make money in the specialties. But their arguments fell on deaf ears. Even the vanity appeals of “you’re too smart to be a GP” and “you’ve got great hands for surgery” didn’t sway me. I ended up becoming the only FP in my medical school class. I guess I heard a different drummer. I have thought many times about what attracted me to Medicine. A book by Logan Clendening that I received on my 12th birthday from my aunt Doris was an entrance into the world of science, diagnosis, and mystery. I believe the real attraction was because of one seminal event that always comes to mind as I have grown older. It is slightly hazy in the details but was electrifying in its impact. I was about 10 or 12 and was sick, lying on the daybed in the den, and sensed the atmosphere in the house was tense and acrimonious. Angst is the word that best describes it. My mother and father were beside themselves — I guess from worrying about me, the youngest of their three. My mother was wringing her hands and talking incessantly. My father was grimly silent. The doorbell rang, and Dr. Gutman came in. He was a GP from up the street. He had an office in his house but made house calls. He was not particularly pleasant, but he was our family doctor — our only doctor. The most amazing thing happened when he entered the house: all of the angst disappeared! Mind you, it was not because of science or knowledge. It was not after the exam and the pronouncement of diagnosis and prognosis but when he simply entered the house! He did not enter saying “Shalom” or “Peace to all here,” as rabbis and priests and religious have done for years. He didn’t have to. His very presence enveloped all in the house in feelings of reassurance, competence, compassion and caring. That’s what I wanted to do. That was who I wanted to be. It was not about power or the control of other people’s lives. It was not a learned skill. It was a blessing or a gift. His mere presence was enough to affect peace and comfort. There is something holy about that! Something is sanctifying about that! I hope I have achieved that level of providing comfort and reassurance simply by being a competent, caring, compassionate doctor. Especially of late, a couple of times per week, patients will turn to me on leaving and say, “I always feel better after being here with you.” I find that a great compliment and an affirmation that I have succeeded at my job. Many of the patients I am now seeing have been with me for over 40 years. Some were delivered into my hands. Some I have breathed life into, some I have snatched from the jaws of death and for some, I have been Charon, poling the boat across the river Styx. All have touched my life and shaped my career. I am profoundly grateful for their trust, faith and presence. I have cared about them all. I have sacrificed my time and leisure, many of my family’s needs and my individual interests for their well-being. I don’t regret the personal sacrifice, but I apologize to my family and those around me for their involuntary sacrifice. I have been rewarded with money and prestige, perhaps not as great as many of my colleagues, but enough. The conversations and expressed feelings of my patients are truly priceless. Trying to convey this to the medical students that come to my office is difficult. I tell them that I come to the office not to work but to see a bunch of old friends — and I get paid for it! It is more than any person deserves, and I remain honored, grateful, and don’t ever want it to stop. Source
