Doctors, Money and Pride

Have a good read of this Medscape Report.

Its about Doctors and their paychecks. As usual, and same as last year’s results, the top-earning doctors are Radiologists, Orthopaedic Surgeons, Cardiologists, Anaesthetists and Urologists. That’s American data from almost 25,000 doctors, and the Australian data will probably be quite similar. The poorest paid? Paediatrics, Family Medicine (GP) and Internal Medicine (Physicians). It appears that the less time you spend with the patient, the more you earn.

Other findings in the study to me were even more interesting.

These high earning specialties did not “Feel Rich”. Those who felt rich were the Pathologists, Oncologists, Gastroenterologists, and Dermatologists. And who felt least rich? Plastic surgeons.

Who had the highest job satisfaction? Certainly not those with the big money. Dermatology, Psychiatry, Emergency Medicine, Infectious Diseases and Pathology had the happiest doctors. It’s official. Money does not equal satisfaction at all. It’s almost like, the less you touch a patient, the more satisfied you are. And who were the least satisfied? Plastic surgeons.

But the one thing that I found most concerning was the fact that the study revealed a strong and increasing undercurrent of frustration in the medical field. One of the doctors remarked “I love being a physician, but I hate what is happening to medicine. Too many people are coming between me and the care I provide to my patients.”

Read slide 15. The authors noted:  “The 2012 survey showed far more dissatisfaction among doctors across all specialties. In 2012, just over one half of all physicians (54%) would choose medicine again as a career, far less than in the prior year (69%).”

Why? Why are doctors becoming more dissatisfied? The pay, I hope, is not the reason, because we are well paid. Even if you are the lowest paid doctors, you are still better paid than many others professions. The work is stressful, yes, but isn’t that what makes it fun and challenging? The hours are long and tedious. True, but there are also many other professions where long hours are not even well remunerated. Working long hard hours is the curse of the modern age in general, not a curse of medicine.

Is it perhaps because the humanitarian aspect of our work is being eroded daily by a system that pushes productivity rather than compassion? I know that I spend more time with paperwork and computers than with my patients. I get frustrated when clerical duties overtake my clinical duties, when nurses prioritise papers and protocols over patients. The job of doctoring is now weighed down by so many forms and procedures. Productivity levels, performance indicators, financial targets are now the measures of a doctor’s competence.

What is the solution? No simple ones, obviously. Medicine is becoming so much more complex with time. Many years ago we started employing business-minded people to help us run the business of medicine, so doctors can get back to real doctoring. Now this has come back to bite us. The same people we asked to do business are now making us do business. The language of business is applied into Medicine, with bad results. Patients are not happy, and doctors are frustrated.

How can I change that? How can I turn the tide of doctors’ dissatisfaction? Can I lead a new generation of satisfied doctors into an optimistic future of medicine and surgery?

I can’t change the system, but I can change myself. I will begin by taking pride in my work as an ENT Surgeon in Training. I have seen how a surgeon in love with his work is truly an inspirational being. When my patients, nurses and colleagues see me loving my work, and being fully satisfied, I hope they will catch my disease.

What else can I do to turn the tide of dissatisfied doctors?

On the getting of wisdom

Every medical and surgical specialty is exploding with knowledge. There are so many wonderful things going on in the amazing world of ENT. The future for our patients is bright, that is, if we can translate and materialise what we have learned into our day to day practice as surgeons.

The best of the best in Otorhinolaryngology Head and Neck Surgery came to Adelaide for a 3-day conference. In fact, the axis of the earth moved a little. There were so many ENT surgeons in one place it became the centre of the universe. As a trainee, I saw some great surgical leaders and innovators pushing the boundaries to provide better care for our patients.

Beside gaining much surgical skills and knowledge, it was also a time for me to mingle and rub shoulders with the surgical elders and heroes of my ENT community.

Here are 3 things I learned at the Conference:

1. The patient is the focus, not the disease.

As a trainee surgeon I need to always remember that everything I do should be focused on the patient. Every new research, new developments, new procedures, and new equipments are designed with the patient in mind. This focus and single-mindedness is what separates the great surgeons from the good. I can see that the great leaders of my specialty always place the patients’ interest as an ultimate priority.

2. Surgical advancement is based on hard work and sacrifice.

These great surgeons toil and struggle. They work harder and longer than their peers. They push hard. They persist. They think outside the box. They do certain things that are not normally done, often making many big sacrifices along the way. So how much am I willing to sacrifice?  What am I willing to sacrifice on the altar of surgical advancement? My family? My health? My faith?

3. Surgical humility is the key to surgical satisfaction and longevity.

This surgical trail is a long, tough and lonely road. It takes on the average, 15 years to become a surgeon, 6 days a week doing 14-16 hour shifts and research pursuits in addition. Its tough and rough. The surgeons I look up to are those with what I call surgical humility.  They are content doing what they do. They find joy in the simple things they do. They are honest when reflecting on their outcomes. They are happy to accept responsibilities for their complications, and they are content with not having to be the top dog in town. These are the happy surgeons.

Would these 3 be also applicable to what you do?