Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • 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

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

Post navigation

< 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

  • How subjective likability practices undermine Canada’s health workforce recruitment and retention

    Olumuyiwa Bamgbade, MD
  • Why judgment is hurting doctors—and how mindfulness can heal

    Jessie Mahoney, MD
  • Why evidence-based management may be an effective strategy for stronger health care leadership and equity

    Olumuyiwa Bamgbade, MD
  • The gift we keep giving: How medicine demands everything—even our holidays

    Tomi Mitchell, MD
  • From burnout to balance: a neurosurgeon’s bold career redesign

    Jessie Mahoney, MD
  • Why working in Hawai’i health care isn’t all paradise

    Clayton Foster, MD
  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

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

  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • 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...