Good Doctors are Bad Patients #illumedati 1


Last time on Medicine Mondays, we talked about Residency Interviews and then also Traveling for Interviews on Whatever Wednesdays.

I’m going to switch gears today and talk about how “Good Doctors are Bad Patients”. This is kind of pseudo follow-up to my prior post, Good Doctor, Bad Doctor, Bad for Doctor.


So what do I mean that Good Doctors are Bad Patients?

Well, what are some of the personality traits of a “good doctor”. Someone with a good knowledge base and empathy maybe? The desire to help others? The truth of the matter is there are a ton of personality traits which make up a “Good Doctor”. However, I think a common one is “self-sacrifice”. I would say the majority of doctors didn’t go to medical school for money, fame, or prestige or anything along those lines.

The road is simply too long and too hard to “fake it”.

So, it is my belief that the majority of doctors and nearly 100% of good doctors have the trait of “self-sacrifice”. I would also venture to say that the majority of doctors develop an extreme degree of delayed gratification by the time they finish… which leads to financial problems down the road. I caution about this in my The Biggest Mistake of Your Life post and encourage everyone to browse my previous posts.

So, self-sacrifice then. It happens all through undergraduate, medical school, residency, and as an attending. The patient always comes first. And the patient always should come first… for the most part. However, one point where I feel you must draw the line is at your own health.


I haven’t been on Twitter that long. However, in my short time on there I’ve already seen a few residents post to Twitter about whether they should go see a doctor or not.

If you have to ask Twitter whether to see a doctor.. and YOU’RE A DOCTOR —> GO SEE A DOCTOR

The truth is that you know you have to go to see a doctor, you’re a doctor! However, you want confirmation that it’s ok. You feel guilty. You’re a doctor you’re not supposed to be sick. What if because I’m sick, my team can’t handle it, or my patient needs me, or ..?

The hospital isn’t going to fall apart with you. It was still a hospital before you were there and will continue to be so after you leave. You are an important part of the team, and you are irreplaceable. However, the team will manage. It’s not just you caring for the patient, the team is, the whole hospital is. But you… you are irreplaceable, take care of yourself.

So I’m going to tell you all now, if you, a doctor, think you need to go see a doctor… don’t post on Twitter asking for permission. I give you my permission, and all the other doctors give you their permission. And if they don’t give you their permission, then they are forgetting something very important:

Doctors can be patients too. The patient always come first. So, even when the patient IS a doctor. They come first.

We are not superhuman beings with mutant healing factors like Wolverine. We are only human. Sometimes we think we are more than that, and maybe sometimes we try to be. However, we still have the same heart, lungs, and insides as everyone else. We can be hurt. We bleed. We get sick.


The culture of medicine doesn’t make sense:

Show empathy to all your patients… but don’t show any for your colleagues. It it seen as weakness to call out sick. Tough it out. Suck it up. Do it for the team.

I never took a sick day in internship or residency. Notice I didn’t say “I never got sick”. No, I said “I never took a sick day.” Those are two very different things.

My wife is as strong as they come, and on her trauma surgery rotation as a student she tried to call out sick because she was deathly ill. Her resident told her “You can’t call out sick, you’re a med student.” and made her come in. They placed an IV and she walked around the service with an IV pole for the day.

Some of you may say… Oh wow, “that’s hardcore” or “that’s bad ass”. I said it when I was a med student. The truth is, it’s neither of those things. It’s horrible.

This culture needs to change, and I think it is… slowly but surely.


Your mental health is extremely important. 

If you have asked yourself “Am I depressed?” or told yourself “I’ve never felt this ‘sad’ before.” or something along those lines, then you need to make an appointment to see a psychiatrist. Get help sooner rather than later. Don’t feel guilty or feel weak. Don’t ask whether you need to be seen or not.

If you don’t feel right, then you don’t feel right, and you’re are not alone: Depression is more common than you think: (Medscape Article)

“A survey of American surgeons revealed that although 1 in 16 had experienced suicidal ideation in the past 12 months, only 26% had sought psychiatric or psychologic help.”

“In every population, suicide is almost invariably the result of untreated or inadequately treated depression or other mental illness that may or may not include substance or alcohol abuse, coupled with knowledge of and access to lethal means. Depression is at least as common in the medical profession as in the general population, affecting an estimated 12% of males and up to 19.5% of females. Depression is even more common in medical students and residents, with 15-30% of them screening positive for depressive symptoms.”

“However, because of the stigma associated with depression in almost all cultures, which seems to be greatly magnified among medical practitioners, self reporting likely underestimates the prevalence of the disease in medical populations.”

“Denial is depression’s biggest ally… and your worst enemy.”

from @ERscribelife

-Sensei

Agree? Disagree? Questions, Comments and Suggestions are welcome.

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