NYT: Medicine's Search for Meaning (David Borstein)

Presenting a patient to my Cardiology attending is how I would imagine asking out a beautiful woman is like: he is bored and unimpressed by everything I say and yet I cannot help myself from trying again and again. He is a handsome middle-aged man with ethnic origins likely from somewhere around the Caspian Sea, and always wears a crisply ironed shirt underneath a navy sports coat. He wears no tie to complete a persona of casual authoritativeness. I would be more enthralled if his half-closed green eyes looked at me for longer than 3 seconds before drifting to the fellow; I would be more in love if he actually ever let me finish a sentence without cutting me off...to ask the fellow. And yet, I am amused by the challenge of somehow impressing this beautiful withholding creature, and am completely, utterly prepared never to succeed.

It's only fitting that I would read an article today in the NYT about how burnout in medicine is often the product of abusive and neglectful behaviors that comprise the hidden curriculums in medical education. A lot of lip service is given to physician qualities of compassion, empathy, patient advocacy, etc. But what is actually rewarded in medical education and beyond are efficiency, quantifiable "successes" e.g. seeing the most number of patients in as little time as possible, and, subsequently, an objective detachment. Somehow medicine, supposedly the most humane and noble of professions, often encourages the development of cold, egomaniacal behaviors. However the problem is that a God complex doesn't actually make you a God, and according to the article more than 50% of physicians today report symptoms of burnout and dissatisfaction with their profession.

I understand the time pressures that impair patient care, and I do not blame physicians for responding to these pressures with professional detachment. When you are pressured to see so many patients in a short amount of time there is simply no possible way to establish the trust that is so essential for the patient-doctor relationship. I find myself feeling disillusioned at times, even so early in my career, when I no longer feel like I'm working to serve my patients but rather just trying to keep my head above the water as my attendings and institution look on waiting for the weak to weed themselves out. The thing is my bosses are likely experiencing the same feelings themselves in a vicious cycle that continues to repeat itself.

For my choice of residency I'm going to make it a priority to train somewhere that focuses on patient care more than hierarchy and metrics. Just looking for some heart.

"Great doctors don’t just diagnose diseases, prescribe medications and treat patients; they bring the full spectrum of their human capabilities to the compassionate care of others."

1) Medicine’s Search for Meaning
2) Hidden Curriculum 
3) Healer's Art Course
4) Being emotional during decision making - good or bad? An empirical investigation