National Doctor’s Day is Monday, March 30, which perhaps is fitting, because all the doctors I know do a lot of doctoring on Mondays.
It seems like everybody gets a day in our modern world. I don’t know if this is a Hallmark conspiracy or simply an extension of the “we-are-all-winners society” that we live in.
Doctoring has undergone a sea of change in the 30 years since I graduated from medical school. The technology explosion has been nothing short of miraculous. The cell phone and laptop did not exist during my training. Even desktop computers were rare, exotic and had green lettering. The World Wide Web was still in the future.
We learned about how the body works from books and lectures, models and cadavers. We studied health and disease, and spent limited time on treatment. The correct diagnosis was all important; you could look up the treatment in a book (and learn it during internship and residency).
There were no business courses in medical school and 90 percent of the doctors were set up in a practice working for themselves, within 150 miles of the medical school they attended.
Doctoring traditionally was a service occupation that was not highly paid. Given our early treatment options – leeches, crude plant extracts and the occasional heavy metal (mercury) – that was perhaps rightly so.
But the world has changed. An unimaginable array of very sophisticated treatments, based on good science, has tamed some of the fiercest diseases. However, the mountain of medical research generated every week is too much for any one man or woman to keep track of.
We have divided and conquered; someone does pediatric heart surgery, and someone else takes care of the eyes. “Specialists know everything about nothing, and generalists know nothing about everything” – is the old joke.
Medicine now exists in clean modern antiseptic facilities, with dozens of computers readily available to assist. I even have one in my stethoscope – lest I need help identifying a murmur. It has been said that an MRI could replace a roomful of neurologists. Heady times indeed!
But the important stuff hasn’t changed. I remember my training. I had the common notion among residents, that I did all the work taking care of the patient, and the attending physician had the easiest job in the world.
That persisted until I got out in the world and saw my first patient alone. The security blanket of the wiser, experienced doctor invisibly backing me up was greatly missed.
Every doctor has that moment: “Oh my God, it’s all me. What if I don’t know the answer?” A lot of Pepcid and Tums were sold to young doctors, but gradually we became wiser.
Every time we walk into a room and see a new patient we know we will meet a unique and special human being, troubled by injury or disease, and not at their best. They will tell us their story as they are able, full of facts, opinions, internet research, and red herrings. Some favor a Newtonian (ordered) chronology and others embrace the uncertainly of quantum universe.
Our patients are equal partners in the relationship. It is not simply enough to diagnose and treat them, we must also make sure they understand the disease enough to make wise choices.
Yes, medicine has become complicated – the training, the malpractice, the pharmaceutical industry, fee schedules and insurers.
But when I am in a room with a patient that all falls away, and I think I have best job in the world.
Maybe we should celebrate and take 10 minutes for a lunch smoothie on Monday!
Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.
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