Before you can achieve something, you have to know what it is that you are trying to achieve. Thats pretty easy when it comes to some things. For example, a good running back runs for a lot of yards and scores a lot of touchdowns. A good cook creates food that people like to eat. A good salesman produces the most profits for his company. But what is it that a good doctor does to be considered good?
My goal is to be a good doctor but I am not sure what this entails. I was once told that patients judge doctors on the 3 A's (in order of importance): Availability, Affability, and Ability. The emphasis here is that no matter how good you are, being nice and being there are what matter most. The alternative viewpoint is that results are what matter. A good doctor is a doctor that can cure you of whatever ails you. If he or she is nice, so much the better, but this certainly doesn't come into the equation of defining a doctor's quality. Both of these measures of a doctor's quality are from the patient standpoint. If you ask doctors who they consider to be good doctors, they will envariably point to a physician with impeccable credentials, the most publications, the best diagnostic skills, or someone who generates the most profit for the hospital. In short, physicians judge other physicians not on character or medical results but on criteria that are often not even available to the public. Do you know where your doctor went for medical school, residency, or fellowship? Do you know which journals he or she has published in? In a cynical moment, one of my attendings once quipped that "You go into academic medicine if you want to be thought highly of by your fellow physicians and you go into private practice if you want to be thought highly of by your patients. " Maybe there is some truth to that.
In Doctor, Edward Rosenbaum, himself a physican, writes about his experience as a patient. He ends the book by commenting on what he thinks makes a good doctor: Ability and Integrity. In Dr. Rosenbaum's mind, those are the only two things that matter when deciding if a doctor is good. It sounds simple enough but an entire book can be, and was, written on what those two terms entail.
While I try to figure out what being a good doctor entails, I try to follow the following rules that were passed down to me from one of my attendings. Maybe this isn't the key to being a good doctor, but I hope these rules will at least keep me from being a bad doctor:
Sounds pretty simple. Be honest, be considerate, and have fun. If it is really that easy why don't we have more good doctors?1) Be honest. At first glance this just means don't lie to others. But, it also means be honest to yourself -- know your limitations and when to ask for help. And finally, being honest means being reliable. If you say you're going to get something done, make sure it gets done.
2) Treat every patient as if they were family. This doesn't mean get emotionally tied to their case so that you can't make clear decisions. What this means is, pay as much attention to detail on each of your patients as you would if they were your family member, and advocate for each of your patients as if they were your loved ones.
3) Have fun. You can't do a good job unless you enjoy what you are doing.
