Every generation in medicine is tested in one way or another, whether by innovative leaps in diagnostics and therapeutics, pandemics, or the many, many social and political forces putting pressure on our healthcare system. I had the privilege of hosting the SSVMS Past President’s Luncheon recently, where the room was wrapped in printed quotes from decades of past presidents. This gave a glimpse into the challenges and opportunities that the profession of medicine has faced, and is continuing to face. These quotes were collectively, and somewhat unexpectedly, very moving. So much has changed over the decades in how medicine is practiced, and it certainly appears that we are on the cusp of even more exponential transformation in research and clinical practice.
Simultaneously, we have collectively had to navigate an ever-increasing deluge of regulation, compliance, and both public and private-payer bureaucracy. Medicine is a tough sport these days, and we have reason to be demoralized. Much of our profession has been systematically reduced to just another cog in the health care industrial complex, leading to widespread burnout.
We face profiteering and consolidation. State and federal cuts to health care for our most vulnerable patients. Misinformation and attacks on science. The concept of evidence-based practice itself is being called into question, and the growing acceptance of ‘alternative facts’ being peddled and legitimized by the likes of Robert F. Kennedy and others will have long-lasting effects on our communities.
So what’s next for us, here in the Capitol region of the world’s fourth largest economy? How do we maintain both the trust of our patients and our own dignity while continuing to serve our communities? We must unreservedly reject the ever-encroaching influence of bureaucrats, conspiracy theorists, and religious ideologues attempting to dictate what health care should look like and how we should practice medicine. We must continue to expand our voices into social and public health, electing more physicians to every level of government in order to elevate our core cause: caring. Caring for our patients, our systems, and each other.
This can all seem very daunting at the individual level, but there are plenty of things each of us can do to reinforce respect for the practice of medicine. A few suggestions:
- We must not mistake our profession of service for martyrdom. Even small changes can reestablish professional boundaries that seem to have slackened over the decades, particularly with respect to health systems and contracts. Normalize uninterrupted time for nonclinical obligations. Reject overloaded clinic schedules, and build in protections against maximizing productivity. Reaffirm and enforce zero-tolerance policies for violence against physicians, verbal or physical.
- In our clinical practice, we must focus on taking care of patients where they are. Every patient connection is an opportunity to dispel misinformation and offer an evidence-based recommendation, no matter where the patient may land according to stages of change theory. This also requires each of us to remove judgment or avoid becoming triggered when we hear things like ‘vaccines cause such and such…’, or ‘well, I read on Facebook…’.
- Finally, we must become better patient advocates, which is no small feat amidst our many competing obligations. This could mean many things beyond running for office, like reporting egregious prior authorization denials to the state, writing an op-ed, or joining a local health campaign.
While our profession has changed dramatically over the last several decades, physicians remain among the most trusted voices in every community. And it remains our choice whether to accept, own, and empower that respect.
