Sunday, July 3, 2011

So what does it mean to "be a doctor."

Edit:Please read the first part too!

Continuing with my last post on some non geriatric thoughts, the author of the NYtimes commentary told a medical student that if she wanted to be a doctor, she should just "be a doctor" implying that caring about a family life may not be compatible with being a doctor. Or at least her image of being a doctor. So it got me thinking, how would this author define "being a doctor?" I think her commentary raises more questions than answer.

My main question is what is the metric of a "being a doctor." How does one know that he is "a doctor."
1. Is it the number of hours per week? Is it 20, 30, 40, 60, 80, 120? Clearly for the author, 20 is not being a real doctor. But how does she draw the line?

2. Is it how many nights per week one takes call? She thinks you have to risk some interruption. How much is enough? Once a week, every night or something inbetween?

3. How many patients per hour does it take to be a real doctor? Apparently in her opinion, you have to see as many as men do. But why is that the metric? Is it 4 patients per hour or 12?

4. Other questions: Does a real doctor have to teach? Do research? Publish? Go to conferences?

At what point does caring about your personal life make you cease being a real doctor? Does she set no limits at all? If she does, how does she define herself as being a real doctor?

5. How many years should a real doctor work? In a medical school setting, we've all met docs in their 80's who have no desire to retire. Is that what real doctors do? (WWRDD-what would real doctor do?). Is it wrong for someone in their thirties decide to be doctor if their careers are shorter? How about in their 40's or 50's even?

6. How much vacation can a doctor take? As you can see, the questions become one of bravado: I work harder than you, that makes me more of a real doctor? Which specialties are real doctors? If you are a pathologist and never take call, are you a real doctor?

At the end of the day, I think the crux of the matter is that if by putting your personal life first, and by doing so you practice medicine in such a way to put patients at risk of bad outcomes, or you don't even care about the quality of medicine you are practicing as long as it fits your lifestyle, then you need to consider stopping the practice of medicine. That's unfair to patients. But if you take your job seriously, make sure your patient are well taken care of, your patients are satisfied and you practice good quality medicine, then you are "a doctor."

1 comment:

muddywaters12strg said...

That is a good question that you pose. I am the son of a geriatrician and I grew up around all sorts of doctors. I've seen it all. I've visited my father in hospitals, followed him to assisted living facilities, and even assisted him in his job by dating charts. I don't think there is a real way to define a doctor. Its like my dad told me, "What do you call the person who graduates last in his medical school class?"..."Doctor".