Seeing the Doctor's Heart

“Nobody cares how much you know, until they know how much you care.”

—Theodore Roosevelt

I recall my father saying that his work as a doctor was supposed to be challenging. “We save lives every day … what have you done lately?” was his typical comeback when someone would malign the medical profession.

From my observations I can tell you that he did save lives. I’m not certain it was every day, but I know he worked at it very hard—every day. And his patients revered him for his efforts.

I’ll remember forever what the wife of one of dad’s patients with serious heart disease said to me. “Your father gave him 10 years he never would have had,” she told me. “My husband was a self-made man, very independent, and wasn’t someone who listened to a lot of people but he listened to Dr. Kelly. I got all those extra years with my husband because your dad truly cared about us. He made the difference on life or death.”

I was with my father the night this man (who also became dad’s friend) did die. Dad was just about to go to bed when the emergency call came. He quickly when to the scene, but too late, the man was already dead from a fatal heart attack.

Words can never describe the expression on my father’s face when he returned home afterwards. That night, I think, his heart broke a little too. For me, it was a genuine view into the life of a physician. All very human.

There’s an interesting book out this year, Doctored: The Disillusionment of an American Physician by Dr. Sandeep Jauhar. Like my father, he too is a heart specialist.

As we ring in a new year, I thought I’d emphasize some of the positive things that Dr. Jauhar believes are necessary to “reverse the disillusionment that is so widespread in the medical profession.” Above all, the thing that today’s physicians must do to recapture their love of medicine is to embrace the “human moment.”

The medical profession “is about taking care of people in their most vulnerable states and making yourself somewhat vulnerable in the process,” Dr. Jauhar wrote in a recent Wall Street Journal essay. “Those human moments are what others—the lawyers, the bankers—envy about our profession, and no company, no agency, no entity can take those away. Ultimately, this is the best hope for our professional salvation.”

His other recommendations:

• “Create attachments with patients, making a difference in their lives and providing good care while responsibly managing limited resources.”

• “Publicize clinical excellence, for example (public reporting of surgeons' mortality rates or physicians' readmission rates is a good first step), or give rewards for patient satisfaction.”

• “Replace the current fee-for-service system with payment methods such as bundled payment, in which doctors on a case are paid a lump sum to divide among themselves, or pay for performance, which offers incentives for good health outcomes.”

• “Don't simply reward high-volume care but also help restore the humanism in doctor-patient relationships that have been weakened by business considerations, corporate directives and third-party intrusions.”

• “Fulfillment in medicine, as with any endeavor, is about managing hopes. Probably the group best equipped to deal with the changes wracking the profession today is medical students, who are not so weighed down by great expectations.”

• “American doctors need an internal compass to navigate the changing landscape of our profession. For most doctors, this compass begins and ends with their patients. In surveys, most physicians—even the dissatisfied ones—say the best part of their jobs is taking care of people. I believe this is the key to coping with the stresses of contemporary medicine: identifying what is important to you, what you believe in and what you will fight for.”

• “Medical schools and residency programs can help by instilling professionalism early on and assessing it frequently throughout the many years of training. Introducing students to virtuous mentors and alternative career options, such as part-time work, may also help stem some of the burnout.”

Happy New Year doctors!

Source: The Wall Street Journal