Well, it's been about 10 days since my last post – so I'll get rolling again with a "Doogie Howser" philosophical entry.
Meeting with a medical student about her career choices last week, I was reminded once again that making a decision about what to do for the rest of our lives is no easy task. I'm not sure when I decided to be a family physician, but I think it was before medical school. In my student's case, I was struck by how she had so much insight into her need to "feel important."
Rounding on the nephrology service, she felt important because she was "the expert." Other physicians asked for help .. which made the nephrologists important. The same thing happened on Surgery, Infectious Disease, etc.
Yet this student does so well listening to (and really hearing) her patients that she has also been drawn toward primary care and psychiatry. Yet these specialties don't feel so important to her .. she doesn't see the primary care physician as the expert.
I was struck by how clearly and honestly she could express this to me. Many other students struggle with this .. and I often find the ones who can express this need to be important and be the expert are the ones who need it the least.
Removing a wayward q-tip from a patient's ear this morning … I felt less important than simply helpful. Yet this is what our work is about .. and indeed, we must maintain our humility. I counseled the medical student that the initial thrill of feeling important wanes as time marches on.
Very nice, very insightful. Thank you.
I’m choosing a career now, too, as a new 4th year. I think I flirted with that ‘importance’ feeling, before focusing on who it was I was trying to impress… and what we’re really there for. I think you’ve stated it beautifully.
After 10 years out of residency I have concluded that most of what we do in FM is to act as a shock absorber for the problems of life for our patients.
Rarely we can make a huge difference, much more rarely we can save a life, but I think that is the case in most of “talking” medicine (it is not the case with procedural specialties).
If your student wants to feel important … that’s an issue I would think she needs to work out within herself or in counseling. Everyone is important, what makes you important is how you feel about yourself, not how others feel about you.
Thanks for this post, Dr. Reider. It’s nice to hear this perspective on medicine. I’m also in my 4th year and figuring out residency stuff and the whole “what i want to do when i grow up” thing. I’m leaning strongly towards family medicine, and unfortunately I’m getting a lot of “you’re too smart for that” or “you need to be an expert in one specialized area instead of a jack of all trades” (part of the northeast attitude). I’ve come to see my role as a future doctor as being helpful, as you so well stated, and as being someone dedicated to working on important factors that contribute to health and wellness (instead of only focusing on specialized hospital care of disease).
The “hierarcy” attitude of medicine isn’t always easy to deal with. I’ve recently posted about some of my experiences with residents and physicians about career choices – http://totheteeth.blogspot.com/2004/07/back-on-hospital-floors-patients-are.html.