What's Wrong with Us?

Pogo's famous line applies here: "We have met the enemy and he is us."

Once upon a time, doctors would proudly guide their children to follow their footsteps into the career of healing. Now the common theme heard in doctors' lounges is, "I wouldn't let my son or daughter go to medical school."

Cultural anthropologist Jon-Henry Pfifferling, PhD, has studied us for years. He calls American physicians "the most hurting people on Earth." How have we fallen so far?

What's wrong with us?

There is no denying that times are hard for medicine as a business, but these still ought to be pretty good times. Even with all of our difficulties, most doctors make an excellent income. Today we can call upon an ever-expanding medical technology, which really is miraculous and would have left our predecessors gasping. Yet, fewer and fewer of us seem to enjoy what we do any more. We look outside ourselves and see our troubles as arising from here or there. Do our troubles really come from outside sources? I don't think so.

It is very tempting to fall in with so many of our colleagues and play the blame game for medicine's plight. Managed care, HMOs, for-profits, HCFA, Big Government, greedy insurance executives, greedy patients, greedy doctors (always someone else), hospital administrators, case managers, etc.-our list is endless. The only culprits missing are you and I. Yet, the only things we can really change in our world are our attitudes and ourselves. When do we start on that project?

Pogo's famous line applies here: "We have met the enemy and he is us."

What would you say to a patient who asked for advice on his or her life problem? "Doc, I hate what I do. I find myself angry all the time. I feel like I am Fate's plaything, and I am losing control of my life and myself."

Would your advice be to just stay quiet and keep going to work? I hope not. Would you advise career or personal counseling? That would be appropriate. Would you offer your patient support? You should.

But what if this patient is you?

Are you continuing to practice medicine even though demoralized and dejected? Do you feel yourself getting a little angrier week after week and wondering when the explosion will come? Are you depressed? Are you afraid? If your emotional condition is anything close to these examples, are you admitting it to yourself? Are you seeking help? Doctors are notoriously poor at taking care of themselves. These issues should not be ignored.

Perhaps you aren't enjoying your practice as much as you used to but your condition is not so desperate. What can you do? You can add something to your professional life to give it more meaning. Through your medical society you have several opportunities to serve others in special and meaningful ways. Many other agencies offer important paths of public service as well. Breaking out of the productivity game for at least a portion of your life could make all the difference.

One thing that doctors used to have-and have lost-is our sense of belonging. This is an unfortunate part of our post-modern condition and not just limited to physicians. Physicians of two or three generations ago were rugged individualists in a way that few of us are today, but they took deep pride in belonging to organized medicine and being colleagues to each other.

We don't think that way any more, and suffer professional loneliness. Your medical society is evolving from a county-based to a regional organization. We run the risk of further diminishing our connectedness and sense of belonging. Yet, we can use our reorganization to increase cohesiveness. Today's communications (e-mail and the like) allow us to connect despite living far apart. Our children understand this. Generations X and Y use e-mail and chat rooms as their media of choice; we can too. We aren't too old to learn.

Take a look in the mirror. Are you satisfied with your professional life? Do you feel connected with your profession? If not, what are you going to do about it? How can your medical society help you? Let us know.

edpmg@inforum.net