Saturday, June 03, 2006

rainy saturday idealism

So I awoke this morning to the sound of the work truck backing up the driveway. They're here to put in the new kitchen counters. They were supposed to come yesterday, along with the plumbers, so I could have a functional kitchen. The plumbers showed up yesterday afternoon as planned, but the installers did not. So here they are now.
It's gray and raining here today and fairly dreary. So I guess it's a good day to have workmen tromping in and out of the house, drilling and filling the air with the smell of silicone. Mmm, silicone.

I spent the morning sitting on the couch trying to develop a new curriculum for professional development, something that has been fairly ignored in our program to date. But now we have an RRC site visit coming up and our new program director is suddenly very interested in what research and advocacy projects the residents are involved in. Not very many, that much is clear. How many residents attend national professional society meetings? Hardly any. How many residents have an updated CV? Probably only the ones graduating who nad to finish them for their job applications.
So the idea we came up with is to have a certain number of PEDs, or personalized education days, to devote to professional development. The pun wasn't my idea. But it's a good idea. Maybe it will inspire people to try again to make a difference on a larger scale, something that seemed to be more expected when we were med students.
I think we've lost something in medicine of late. A sense of professional responsibility. Collectively, we've lost our way and have gotten bogged down in the quagmire. A respected surgeon from my med school once said, “There are three professions in this world: law, clergy and medicine.” The implication of his words is that being a doctor or a lawyer or a religious leader entails more than going to work everyday and going through the daily grind. There is a professional duty and responsibility that pervades every aspect of life.
In this era of the 80-hour rules, rising health care costs, and cynicism about the practice of medicine in general, there is the temptation to do only what is necessary to get through the day. The practice of medicine is becoming ever more specialized and compartmentalized. The 80-hour work rules that were intended to protect us from grueling hours and fatigue have only served to give us a sense that what we do is shift work; our hours are up and we punch out, not literally but emotionally. There is an emphasis on more efficient delivery of care and RVU-generation that attendings have likened to working in a factory: 15 minutes in one room, then on to the next and the next and the next. There is an emerging sense that we, as physicians-in-training and future leaders of our profession, cannot make a difference. This in contrast to the dewy-eyed new medical student who fought to get into medical school so they could make a difference in the world and help people. There has never been a greater need to promote professional development and responsibility in our learners, to re-instill in them that sense of passion and motivation to do good works.
I'm not sure that this new curriculum will change anything, but maybe it will give someone an opportunity to try. An idealistic attending that I respect enormously for his passion and dedication to some of the most desperate children in this world once said to me, "We've got to save the world." At first, I thought this was a silly thing to say. But then I realized that he was right.
Who else will if we don't?
Here's a rainy day toast to passionate idealism...

1 comment:

Wrkinprogress said...

I truly hope you can convince your colleagues to adopt your way of thinking. Recently I've been fortunate enough to be treated by a group that seems to think as you do -- they even reminded me that they are open on Saturdays in case I needed treatment over the weekend. That kind of care is not common, sad to say.

As I've said before, every time I read your blog I am encouraged. Thank you for that. Your outlook is like a proverbial ray of sunshine in a sometimes too-dark world.