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

Practicing medicine with conviction

Arthur Lazarus, MD, MBA
Physician
September 28, 2023
Share
Tweet
Share

What does it take for physicians to practice with conviction – to practice medicine with a sense of confidence and commitment, passionate about your work? What factors allow medical students to enter the resident pool each July and turn their timidness into poise? How do you learn to stand by your medical convictions and base your decision-making on a deep understanding of the patient combined with the latest evidence-based practices? Here are a few thoughts that come to mind.

First and foremost is continuous learning. You can practice with conviction by being well-informed and up-to-date about the latest medical advancements, research, and practices. This includes attending medical conferences, participating in professional development activities, and reading the latest medical journals.

I suggest you read (or skim) at least one major weekly medical journal each week, like the New England Journal of Medicine or the Journal of the American Medical Association, and two highly regarded journals in your specialty. A daily or weekly online newsfeed is also useful. Why not listen to a podcast on your way into work?

The pace of medical advancements can sometimes be overwhelming, making it challenging for you to stay updated. You must find the time to read; however, because reading bolsters your confidence and strengthens your commitment. During rounds, I frequently distributed articles relevant to patients on our service, and I was proud to be called “Article” Lazarus by the house staff. I could always take a ribbing in the name of patient care.

The more knowledge and experience you have, the more conviction you will have in your decisions and actions. This comes from years of practice, dealing with various cases, and learning from successes and failures – and you will fail, make no mistake about it. The Institute of Medicine wrote “To Err is Human.” I keep a placard in my office that reads: “I am willing to make mistakes if someone else is willing to learn from them.”

Doctors with conviction are able to empathize with their patients. They understand their concerns, fears, and expectations, which helps them provide the best possible care. We must never let our empathy wane. When choosing a physician, patients value affective concern as much as, if not more than, technical competence. I am dismayed by studies showing empathy decreasing midway through medical school, before doctors are newly minted. Medical students should realize that physicians who are more attuned to the psychosocial needs of their patients are more likely to have better outcomes.

A physician practicing with conviction adheres strictly to medical ethics. This includes respecting patients’ rights, maintaining confidentiality, and avoiding any form of discrimination. We are at a tipping point where the promulgation of diversity, equity, and inclusiveness initiatives is beginning to eradicate barriers to treatment for minority populations while promoting a more diverse physician workforce. Diversity – or the lack of it – among medical students and physicians affects not only how care is delivered but also the ability to make clinical decisions with conviction and courage.

A nurturing environment is essential to practicing with conviction. Trainees are more capable of rising to a clinical challenge when they are respected and treated well. Our collective experience reveals that it is not a health system or long working hours that guarantee residents become excellent physicians; it’s the conviction and dedication of the people within those systems and who schedule the hours.

In order to practice with conviction, certain barriers must be overcome. The most important is imposter syndrome (IS). People often think of imposter syndrome as a lack of self-confidence, and although that is certainly a feature, the hallmark of IS is an internal feeling of intellectual phoniness, a persistent belief that you are really not bright and have fooled anyone who thinks otherwise. Individuals with IS are high achievers, but they doubt their accomplishments and believe they are unwarranted.

Anyone who dreads being exposed as a “fraud” cannot practice with confidence. You will be saddled with doubts and fears of failing, as well as constant anxiety. Physicians with IS may be less likely to seek help or advice from their colleagues due to fear of appearing incompetent. This can hinder communication and teamwork, which are crucial in the management of patients.

A lack of confidence can also be perceived by patients, potentially undermining their trust in doctors and the profession. The first time I was called on to perform venipuncture on a patient, I was a nervous wreck. My hands were trembling. The patient was keenly aware of my insecurity and refused to allow me to draw blood. My confidence was shaken, and I shied away from performing procedures afterward.

Imposter syndrome can become a self-fulfilling prophecy because it keeps physicians from achieving their full potential. They develop an aversion to being in the spotlight and turn down leadership opportunities. For these reasons and others, discussions about IS should be integrated early into medical student and residency wellness programs and initiatives. Students deeply affected by IS, believing they are truly fakes, should seek psychotherapy.

There may be several conditions other than IS that affect physicians’ commitment to practice. Prominent among them is burnout: exhaustion, cynicism, and reduced professional efficiency. Burnout clearly affects doctors’ commitment and passion for their work. A major cause of burnout is chronic stress often brought on by practicing with limited resources, whether it’s time, staff, equipment, or funding, which can prevent physicians from providing the best care possible, affecting their conviction. Physicians can take action to prevent burnout and seek help early when it occurs, restoring their commitment to practice.

ADVERTISEMENT

Systemic pressures – pressures from insurance companies, hospital administrators, and many other parties tied to the “medical-industrial complex” – can sometimes force doctors to make decisions that they are not entirely comfortable with, thereby affecting their conviction. Moral injury resulting from the failure of health systems to protect physicians during and after COVID has made them rethink their commitment to medicine. Health care institutions should focus on administrative and climate interventions to prevent and address moral injury.

Finally, clinical uncertainties and treatment ambiguities can sometimes affect a physician’s conviction, especially in the context of malpractice litigation. Simply the fear of litigation can make physicians practice defensive medicine rather than making decisions based solely on their professional judgment. The manner in which doctors deal with uncertainty affects their emotional well-being and ultimately their conviction to practice. Your interest in and commitment to practice will skyrocket once you learn that medicine is not always black and white and develop skills to better tolerate ambiguity.

Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA. His forthcoming book is titled Every Story Counts: Exploring Contemporary Practice Through Narrative Medicine.

Prev

The power of memory in shaping human identity

September 28, 2023 Kevin 0
…
Next

Epigenetics and our inheritance to future generations

September 28, 2023 Kevin 0
…

Tagged as: Psychiatry

Post navigation

< Previous Post
The power of memory in shaping human identity
Next Post >
Epigenetics and our inheritance to future generations

ADVERTISEMENT

More by Arthur Lazarus, MD, MBA

  • Why medicine is like a jazz solo

    Arthur Lazarus, MD, MBA
  • Why real medicine is more than quick labels

    Arthur Lazarus, MD, MBA
  • Forced voicemail and diagnosis codes are endangering patient access to medications

    Arthur Lazarus, MD, MBA

Related Posts

  • 3 lessons I’m learning about practicing medicine

    Klaus Kessel
  • How social media can advance humanism in medicine

    Pooja Lakshmin, MD
  • A physician’s addiction to social media

    Amanda Xi, MD
  • The difference between learning medicine and doing medicine

    Steven Zhang, MD
  • Medicine rewards self-sacrifice often at the cost of physician happiness

    Daniella Klebaner
  • Why academic medicine needs to value physician contributions to online platforms

    Ariela L. Marshall, MD

More in Physician

  • When cancer costs too much: Why financial toxicity deserves a place in clinical conversations

    Yousuf Zafar, MD
  • The hidden rewards of a primary care career

    Jerina Gani, MD, MPH
  • Why doctors regret specialty choices in their 30s

    Jeremiah J. Whittington, MD
  • 10 hard truths about practicing medicine they don’t teach in school

    Steven Goldsmith, MD
  • How I learned to love my unique name as a doctor

    Zoran Naumovski, MD
  • What Beauty and the Beast taught me about risk

    Jayson Greenberg, MD
  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • Why I left the clinic to lead health care from the inside

      Vandana Maurya, MHA | Conditions
    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • How doctors can think like CEOs [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • Affordable postpartum hemorrhage solutions every OB/GYN can use worldwide [PODCAST]

      The Podcast by KevinMD | Podcast
    • When cancer costs too much: Why financial toxicity deserves a place in clinical conversations

      Yousuf Zafar, MD | Physician
    • Psychiatrist tests ketogenic diet for mental health benefits

      Zane Kaleem, MD | Conditions
    • The hidden rewards of a primary care career

      Jerina Gani, MD, MPH | Physician
    • Why physicians should not be their own financial planner

      Michelle Neiswender, CFP | Finance

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

Leave a Comment

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

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • Why I left the clinic to lead health care from the inside

      Vandana Maurya, MHA | Conditions
    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • How doctors can think like CEOs [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • Affordable postpartum hemorrhage solutions every OB/GYN can use worldwide [PODCAST]

      The Podcast by KevinMD | Podcast
    • When cancer costs too much: Why financial toxicity deserves a place in clinical conversations

      Yousuf Zafar, MD | Physician
    • Psychiatrist tests ketogenic diet for mental health benefits

      Zane Kaleem, MD | Conditions
    • The hidden rewards of a primary care career

      Jerina Gani, MD, MPH | Physician
    • Why physicians should not be their own financial planner

      Michelle Neiswender, CFP | Finance

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

Leave a Comment

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

Loading Comments...