I hear you.
If it’s that difficult to put patients first, then find another career.
Of course, doctors being overloaded is the fault of the medical community. They do everything in their power to weed out people and thus there’s a shortage of doctors, so they end up being overworked.
I don’t need, nor want, a doctor who can do marathon shifts during residency. I want a GOOD doctor who will have enough time for patients and I suspect there there are a lot of really good men and women who are weeded out because of the system.
If doctors are overworked, blame the system that created the shortage of doctors in the first place.
Our local hospital here by me is one of the best in the state, but there’s high turnover, especially at the pain clinic. My nephrologist has been there for a couple of decades, and I recently learned that appointments to see doctors are routinely triple-booked. The new hospital was built maybe 15 years ago, and it’s my understanding that they’re still in debt.
Medical staff are severely overworked, especially in rural areas where expertise may be lacking, along with funds, and in areas with high Medicaid numbers. When people don’t have to pay, they go in for every little thing.
Thank you for that background, Vermont LT. I should be clear, my irritation was with the subject being interviewed, not the author. I pinged you to this reply because I saw in your post your history in working with the analysis and management of stress in professional settings.
When there are a lot of people anywhere, doctors will always be in short supply.
Unless they find a machine with software that can do all the diagnosis and treatment that is produced from an assembly line and not from a lengthy medical training regimen, doctors (and not just good doctors...ANY doctors) will always be needed far more than they are gotten.
With that in mind, you need to find out how someone is going to perform under stress, and in that terrible process of putting someone in a more-or-less controlled environment of working under some level of direct supervision, you can reduce the risk later of having someone crack under real pressure when they aren’t in that loosely protective cocoon.
It is much like the training US Marines had gone through in the past at places like Parris Island. They deliberately tried to put recruits under severe and unremitting stress in a semi-protected environment, so if a recruit graduated and went out into the fleet, they had a better chance of performing their mission without becoming functionally debilitated by the stress.
Still. I don’t enjoy seeing people in those stressful situations, even if you know the how and why. Especially if you keep in mind that it may indeed be part of the process to separate the wheat from the chaff, even if people don’t like to admit it.
So, I deal with them a bit, and sometimes I really like it, when you see a resident over time and you think “Yeah. That one will be a fine doctor.” I used to be a jet mechanic back in my time in the Navy, and you would see all the Ensigns and newly minted LTJGs come into the squadron. Being a plane captain, I would watch them carefully as they did their own pre-flight inspection (independent of the one I was tasked with doing) and you could often tell a great deal about that young pilot just by watching them perform this task.
What did they pay attention to? Were they actually DOING the inspection or just going through the motions? I had one pilot who would walk like a zombie, literally kicking the tires, walking around and looking at things with his eyes vacant and his mouth partially open. It was 100% clear to me he wasn’t thinking about the puddle of hydraulic fluid under the wheel well, as much as he was his own affairs.
But I had another pilot who came to us as a LTJG, and watching him come into the squadron, looking no different from any of the others that came before them, all struggling to come to grips with how to fit in personally and professionally in this new environment. Some would show it outwardly on their faces, and some would hide it, but you knew they all grappled with it in some way. And as I watched this new young officer, a LTJG Leenhouts, a tow-headed guy with a very young looking, midwestern boyish face, he was one that I heard the inward voice say “Yeah. That will be one fine pilot.” When he did his preflight, you could tell 100% that this man was 180 degrees the opposite of the young pilot of vacant eye and open mouth.
When he was looking up the tailpipe for stress cracks in the jet exhaust pipe, his eyes and face would assume an extremely focused look, and if you could see a thought bubble over his head, you might actually see “...The Detroit Diesel-Allison TF-41 turbofan engine that powers the A-7 Corsair has a flaw in the design of the tailpipe, where the combination of heat and vibration can cause cracks to occur. The tailpipe must be carefully examined before each flight...”
Of course, it was MY job and the job of the more advanced mechanics in the jet shop to look for those cracks in the metal, but...it was in the pilot’s preflight instructions to perform that examination as well. So when LTJG Leenhouts did this inspection, he was doing as if his life depended on it, which...it did. In contrast, the aforementioned officer would walk up to the tailpipe and turn mechanically to face it to appear to anyone watching he was actually looking, but...he wasn’t.
Just a few years ago, I stumbled across an article with a picture of then CDR. Leenhouts, standing next to the nose of a haze gray A-7 Corsair with dozens of mission stencils painted on it. He stood, hands on hips, his still light blond, still young-looking midwestern boy’s face looking back at the camera. The article said he had led the 1993 initial strike mission against Iraq launched from the USS John F. Kennedy. It also said that he was, at the time, the all-time carrier trap leader for the US Navy. More carrier landings than anyone else. That has probably been broken several times since.
But the point of all this is, there is a commonality to a new pilot entering a squadron and a new physician entering a residency program, and I found the parallel to be very strong, accurate, and quite interesting.
Sometimes, after their residency, One of them may get hired to stay on staff, and when I hear the news, I do a silent fist pump and hear the word “Yessss!” in my brain.
Very rarely, in all my years, have I heard the groan of disappointment in my mind upon hearing the name of a resident in our program who was going to join us, and that is a nice statement of respect for that process. It feels like a quality metric. So, we didn’t have many of them. I had one Resident who had acquired the “God Complex” early on as a young resident, and was quite rude to an older woman who worked for me, a woman who was as smart and dedicated to quality in her work as anyone I have ever known. In the workforce, EVERYONE revered and liked her because she was that good. She was offended by that young resident, and rightly so. So I got the resident alone and said in a not unkindly (yet firm) tone: “Look. You don’t want to be rude to her. She is someone who may save your career someday when she spots your mistake and gets it fixed for you before it can harm anyone. She is someone you want to drop all she is doing to help you.” That resident apologized to her, and in the end, he turned into a pretty good resident.
Anyway, this is all part of the weeding process, and if not weeding, training for handling the stress. That it is often overdone (or at least, has been in the past) is painful to watch, but...once in a while, you see one who figures it out, absorbs things, learns things, and shows real talent that in the end, is real. They stand out, and likely will continue, as that young LTJG Leenhouts apparently did.
Odd. In my career, I have gone through two different phases and types of ducklings turning into flying ducks. Or ducklings into Docs.
And that has been a rewarding part of my career. Just reminiscing...getting close to retirement...I think...:)