Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
  • About KevinMD | Kevin Pho, MD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Discounted enhanced author page
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • Group vs. individual disability insurance for doctors: pros and cons
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Doctor accepting new patients
  • Privacy Policy
  • Recommended services by KevinMD
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The biggest mistake doctors make when purchasing disability insurance
  • The doctor’s guide to disability insurance: short-term vs. long-term
  • The KevinMD ToolKit
  • Upgrade to the KevinMD enhanced author page
  • Why own-occupation disability insurance is a must for doctors

The idealized doctor is dead. Or at least on death’s door.

Igor Shumskiy, MD
Physician
June 22, 2016
Share
Tweet
Share

The American medical establishment has systematically clogged his arteries with paperwork, lined his lungs with rules, and filled his intestines with, that’s right you guessed it, shit. There he lay, in a comatose state, awaiting to be pronounced. Only one thing is sustaining his overworked body.

Idealism.

Four months into my intern year and I’m just realizing how crucial maintaining my idealism — as unrealistic as it may be — is to not only my well-being, but also to medicine. A century-old phenomenon, the disillusionment of the American doctor is a well-known tragedy. In 1927, Francis W. Peabody wrote that “one of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is caring for the patient.” What would Dr. Peabody say today regarding me working 12 to 14 hours per day and only spending 1 to 2 of those hours (if lucky) with my patients?

What do I do with the other 10 hours? Well, over many years the combination of our medical system and the big business of medicine (insurance companies and profiting hospitals) have inadvertently (I hope) created what I like to call the “doctor wheel.” Just like the silly mouse, we endlessly run in our wheel until the day is over, the cage has been opened, and a new doctor is to take our place. Until the next shift of course. The wheel is comprised of notes (admission notes, progress notes, transfer notes, discharge notes), orders, phone calls, order changes, pages, consultations, and so on. A whirlwind of glorified administrative and managerial work that sucks up most of my day. The words thriving and personal satisfaction seem less appropriate than the word survival.

In 1978, Samuel Shem published the House of God. A cynical, yet partially truthful portrayal of the surreal journey through the world of residency. The line, “the patient is the one with the disease” (not the doctor), is frequently repeated in the novel and has stuck with me since. Many times, I have found myself confused, frustrated, upset, and flat out in disbelief that my beloved profession has become what it has, only to remember this line in order to calm me down and bring me back to reality.

As the doctor, I am here to heal, help, support. I am to be the voice for the voiceless. The patient needs me to be sound of mind. But how can this be done when the American medical system is diseased itself? We ask our patients (often overworked and underpaid themselves) to travel long distances, sit happily in waiting rooms for hours, and receive treatments they rarely understand and may not even need — all for a nice profit to the system.

Shem was wrong; I am the one with the disease.

And, I couldn’t be luckier.

I feel pity for those who see the suffering, the inequalities, the redundancies, and the bullsh*t, and do not feel uneasiness, disgust, even anger. The American medical system has “cured” them.

I can only hope it doesn’t cure me. The battle has begun.

Igor Shumskiy is a pediatric resident who blogs at the Journal of a Young Doctor.

Image credit: Shutterstock.com

Prev

They played Taps at my father's funeral. They played it beautifully.

June 22, 2016 Kevin 2
…
Next

The death of a child is an abomination

June 23, 2016 Kevin 0
…

Tagged as: Pediatrics

< Previous Post
They played Taps at my father's funeral. They played it beautifully.
Next Post >
The death of a child is an abomination

ADVERTISEMENT

Related Posts

  • Osler and the doctor-patient relationship

    Leonard Wang
  • Finding a new doctor is like dating

    R. Lynn Barnett
  • Doctor, how are you, really?

    Deborah Courtney
  • Be a human first and a doctor second

    Sarah Murad
  • I challenge you to discuss death

    Emily S. Hagen, MD
  • My grandfather’s death: What I’ve learned about life

    Munera Ahmed

More in Physician

  • MOC patient outcomes: Why recertification doesn’t guarantee quality

    Brian Hudes, MD
  • Why a chief wellness officer hid her medication use for 13 years

    Michael F. Myers, MD
  • Physician patient advocacy: Fighting insurance denials effectively

    Neil Baum, MD
  • Health care’s Upside Down: Addressing systemic dysfunction and burnout

    Ganesh Asaithambi, MD, MBA
  • In the age of AI, what makes a physician REAL?

    Harvey Castro, MD, MBA
  • The cost of clinician absence in the boardroom: a 30-year perspective

    Christopher Mastino, MD
  • Most Popular

  • Past Week

    • Sabbaticals provide a critical lifeline for sustainable medical careers [PODCAST]

      The Podcast by KevinMD | Podcast
    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • Why Medicare must cover atrial fibrillation screening to prevent strokes

      Radhesh K. Gupta | Conditions
    • Menstrual health in medicine: Addressing the gender gap in care

      Cynthia Kumaran | Conditions
    • Teaching joy transforms the future of medical practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Filipino nurses faced higher COVID-19 mortality rates

      Joaquim Diego Santos | Policy
  • Past 6 Months

    • Why the U.S. health care system is failing patients and physicians

      John C. Hagan III, MD | Policy
    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • The American Board of Internal Medicine maintenance of certification lawsuit: What physicians need to know

      Brian Hudes, MD | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
    • Leading with love: a physician’s guide to clarity and compassion

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • Waiting for the system to change causes burnout [PODCAST]

      The Podcast by KevinMD | Podcast
    • MOC patient outcomes: Why recertification doesn’t guarantee quality

      Brian Hudes, MD | Physician
    • When the doctor becomes the patient: a breast cancer journey

      Amy E. Sanders, MD | Conditions
    • Why medical education assessment kills curiosity in residents

      Mythili Ransdell, MD | Education
    • Menstrual health in medicine: Addressing the gender gap in care

      Cynthia Kumaran | Conditions
    • Community ownership transforms the broken health care system [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Sabbaticals provide a critical lifeline for sustainable medical careers [PODCAST]

      The Podcast by KevinMD | Podcast
    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • Why Medicare must cover atrial fibrillation screening to prevent strokes

      Radhesh K. Gupta | Conditions
    • Menstrual health in medicine: Addressing the gender gap in care

      Cynthia Kumaran | Conditions
    • Teaching joy transforms the future of medical practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Filipino nurses faced higher COVID-19 mortality rates

      Joaquim Diego Santos | Policy
  • Past 6 Months

    • Why the U.S. health care system is failing patients and physicians

      John C. Hagan III, MD | Policy
    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • The American Board of Internal Medicine maintenance of certification lawsuit: What physicians need to know

      Brian Hudes, MD | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
    • Leading with love: a physician’s guide to clarity and compassion

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • Waiting for the system to change causes burnout [PODCAST]

      The Podcast by KevinMD | Podcast
    • MOC patient outcomes: Why recertification doesn’t guarantee quality

      Brian Hudes, MD | Physician
    • When the doctor becomes the patient: a breast cancer journey

      Amy E. Sanders, MD | Conditions
    • Why medical education assessment kills curiosity in residents

      Mythili Ransdell, MD | Education
    • Menstrual health in medicine: Addressing the gender gap in care

      Cynthia Kumaran | Conditions
    • Community ownership transforms the broken health care system [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The idealized doctor is dead. Or at least on death’s door.
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...