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Physicians can lead from the bedside

Jean Robey, MD
Physician
September 30, 2016
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A recent movie series called Divergent depicted a dystopia that created five factions: Abnegation (selflessness), Dauntless (bravery), Erudite (intellectual), Amity (peaceful or charitable), and Candor (honest or just) or Divergent (a unique combination of traits that thinks for the whole more seamlessly). This movie’s premise made me wonder: What faction would a modern day doctor belong to?

I recently wrote a piece, “Physicians will take back the beside.” One paragraph seems to ignite many interesting interpretations and emotions. The most interesting was a pre-medical student who felt betrayed by her new order reading the last paragraphs. She struck me as well read and passionate. She felt the entombing of the world of medicine and the failure of the medical society to rise and engage to keep open the stone rolling over the certain grave. The statement, “Physicians should not fight politicians or economist or insurance companies. Physicians should carry on business as usually having and sharing moments of intimacy to remind society what they truly seek in a doctor,” struck a cord and made her feel that I was supporting poor leadership within our order.

Far from it.

As I reflect upon the faction that best exemplifies a physician I conclude we try to tap into all five factions. Society may want to argue that physicians are not so noble and do not exemplify such traits any more than anyone else in society but that is not what the order is selecting for. Any medical school application must constitute elements of abnegation, dauntlessness, intelligence, amity, and candor. I testify that all attributes are demonstrated in any interaction with any patient at all times throughout a day. That is the role we play within society. It is the role we select future physicians for.

Such traits certainly can make great leaders, but my argument is whether the recipe for a physician makes an equally strong politician, economist or actuary. It is not a measure of intelligence or passion or leadership to say a physician makes a great physician and a lesser politician, economist or actuary.

Then what is our role at the table as physicians? Our role remains to serve society with insights and recommendations into well-being. Our role is to help humanity avoid and weather suffering. Our role is to defend against one of a very few inalienable occurrences; Death comes for us all. Physicians are to help ward off suffering and death.

What is our leadership role rooted in? It is rooted in the bedside posture and the human journey. If you are not at the bedside, you are a technician or a researcher or an administrator. If you are going to represent those at the bedside and speak of their interest as it pertains to the bedside, then you speak of those things that preserve the bedside moments and the well-being of the greater society. What is happening at the bedside? A lot is happening at the bedside. It has always and will always be happening unless we let it go for other definitions of a physician. Any doctor has a story about the bedside. They did not get it filling out paperwork, typing on a computer, running  for office, or writing policies. They got them because they were doctoring.

What I see when a council meets and a physician is included, is the council turns to the physician and asks, “How does this help you to help humanity?” It is not different than the role a spiritual leader may have at the table. The spiritual leader is not defending his right at the table nor his role as a leader. He is defined by what he is within society and what he does for society without defense.

What faction would a modern doctor belong to?

Do not declare identity towards a leadership role that does not encompass the order. This is not an invitation to not lead. This is an awareness that we lead by doctoring. We are divergent.

We can lead best from where we stand best. We can lead from the bedside. Lead with your best trait and embrace it for the good of society.

Jean Robey is a nephrologist who blogs at ethosofmedicine.

Image credit: Shutterstock.com

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Physicians can lead from the bedside
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