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“We the [Imperfect] People …”

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A few months ago, I was invited to a retirement party for an old house-officer mate. He wasn't actually retiring, but he was calling it quits from active clinical practice. The food was good and the wine was very good, but the rest of the event left me feeling a bit sour.

The roasts and toasts began with the usual (and well-deserved) compliments by his coworkers. But one of the contributors spoke about how envious she was of my friend because she herself was eagerly anticipating a time when she would no longer have to deal with the stupid and inconsiderate (my words, not hers) patients and parents. She intended her observations to be humorous. However, her scenarios triggered a half-hour-long anecdote-sharing competition during which each physician who stood up tried to one-up his colleagues with a tale of how dumb patients can be. Or, how badly he had been abused by a thoughtless parent who called at an inconvenient time with what he felt was a trivial question.

I must admit that some of the stories made me chuckle until I stepped back and took a longer look at the tableau spread out before me. It bothered me for two reasons. First, we may not like to admit it, but almost every joke is “on” someone. And here I was listening to a bunch of physicians who in the frivolity of the moment were willing to make the patients they served into the butt of their humor.

Physicians must continually struggle with the “we-they” divide. On one hand, it can be important to maintain a reputation and demeanor that give our advice credibility. A patient or a parent facing the unknown of a serious disease is often looking for someone with more “authority” whom can be trusted. On the other hand, we must remember that “the sore throat in Room 7” belongs to another human being who, when all is said and done, is no different from us.

Almost every survey about medical care that I have seen in the last few years contains responses that make it clear that consumers, patients, clients—whoever—want good customer service. Nearly every week I find myself having to remind a receptionist or assistant to reconsider a response to a parent. “What would you have said if your daughter had been the patient?” I think it was Pogo the comic-strip possum who said, “We have met the enemy and he is us.” Customer service boils down to accepting the reality that we are all in this together and so we might as well treat each other as equals.

The second troubling concern that surfaced as I waited for the anecdote swapping to end was that this event had seemed to unroof a festering sore of dissatisfied physicians. Maybe I am reading more into this alcohol-enabled complaint session than I should. But, I have read somewhere that when older physicians are asked if they would encourage young people to enter medicine, many of them reply that they wouldn't.

What is it about being a physician in the new millennium that is making us such an unhappy bunch? Certainly, hassles with third-party payers and the ever-present threat of a malpractice suit can put a few dark clouds in your sky. But listening to these doctors, it sounds as though the day-in and day-out interaction with patients, or certainly with parents, might be a significant source of discontent among some of them.

I've always figured that medicine—and definitely pediatrics—is a people business. And we the people are a quirky sort. We do dumb things with great frequency, and from time to time even the most saintly among us behave inconsiderately. Failure to accept those basic facts of life might be at the root of some of our discontent.

And there might be a good argument for requiring all medical students to have a real job, such as waiting tables, before they start their formal medical education. It might just cut down on the whining.

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[email protected]

A few months ago, I was invited to a retirement party for an old house-officer mate. He wasn't actually retiring, but he was calling it quits from active clinical practice. The food was good and the wine was very good, but the rest of the event left me feeling a bit sour.

The roasts and toasts began with the usual (and well-deserved) compliments by his coworkers. But one of the contributors spoke about how envious she was of my friend because she herself was eagerly anticipating a time when she would no longer have to deal with the stupid and inconsiderate (my words, not hers) patients and parents. She intended her observations to be humorous. However, her scenarios triggered a half-hour-long anecdote-sharing competition during which each physician who stood up tried to one-up his colleagues with a tale of how dumb patients can be. Or, how badly he had been abused by a thoughtless parent who called at an inconvenient time with what he felt was a trivial question.

I must admit that some of the stories made me chuckle until I stepped back and took a longer look at the tableau spread out before me. It bothered me for two reasons. First, we may not like to admit it, but almost every joke is “on” someone. And here I was listening to a bunch of physicians who in the frivolity of the moment were willing to make the patients they served into the butt of their humor.

Physicians must continually struggle with the “we-they” divide. On one hand, it can be important to maintain a reputation and demeanor that give our advice credibility. A patient or a parent facing the unknown of a serious disease is often looking for someone with more “authority” whom can be trusted. On the other hand, we must remember that “the sore throat in Room 7” belongs to another human being who, when all is said and done, is no different from us.

Almost every survey about medical care that I have seen in the last few years contains responses that make it clear that consumers, patients, clients—whoever—want good customer service. Nearly every week I find myself having to remind a receptionist or assistant to reconsider a response to a parent. “What would you have said if your daughter had been the patient?” I think it was Pogo the comic-strip possum who said, “We have met the enemy and he is us.” Customer service boils down to accepting the reality that we are all in this together and so we might as well treat each other as equals.

The second troubling concern that surfaced as I waited for the anecdote swapping to end was that this event had seemed to unroof a festering sore of dissatisfied physicians. Maybe I am reading more into this alcohol-enabled complaint session than I should. But, I have read somewhere that when older physicians are asked if they would encourage young people to enter medicine, many of them reply that they wouldn't.

What is it about being a physician in the new millennium that is making us such an unhappy bunch? Certainly, hassles with third-party payers and the ever-present threat of a malpractice suit can put a few dark clouds in your sky. But listening to these doctors, it sounds as though the day-in and day-out interaction with patients, or certainly with parents, might be a significant source of discontent among some of them.

I've always figured that medicine—and definitely pediatrics—is a people business. And we the people are a quirky sort. We do dumb things with great frequency, and from time to time even the most saintly among us behave inconsiderately. Failure to accept those basic facts of life might be at the root of some of our discontent.

And there might be a good argument for requiring all medical students to have a real job, such as waiting tables, before they start their formal medical education. It might just cut down on the whining.

[email protected]

A few months ago, I was invited to a retirement party for an old house-officer mate. He wasn't actually retiring, but he was calling it quits from active clinical practice. The food was good and the wine was very good, but the rest of the event left me feeling a bit sour.

The roasts and toasts began with the usual (and well-deserved) compliments by his coworkers. But one of the contributors spoke about how envious she was of my friend because she herself was eagerly anticipating a time when she would no longer have to deal with the stupid and inconsiderate (my words, not hers) patients and parents. She intended her observations to be humorous. However, her scenarios triggered a half-hour-long anecdote-sharing competition during which each physician who stood up tried to one-up his colleagues with a tale of how dumb patients can be. Or, how badly he had been abused by a thoughtless parent who called at an inconvenient time with what he felt was a trivial question.

I must admit that some of the stories made me chuckle until I stepped back and took a longer look at the tableau spread out before me. It bothered me for two reasons. First, we may not like to admit it, but almost every joke is “on” someone. And here I was listening to a bunch of physicians who in the frivolity of the moment were willing to make the patients they served into the butt of their humor.

Physicians must continually struggle with the “we-they” divide. On one hand, it can be important to maintain a reputation and demeanor that give our advice credibility. A patient or a parent facing the unknown of a serious disease is often looking for someone with more “authority” whom can be trusted. On the other hand, we must remember that “the sore throat in Room 7” belongs to another human being who, when all is said and done, is no different from us.

Almost every survey about medical care that I have seen in the last few years contains responses that make it clear that consumers, patients, clients—whoever—want good customer service. Nearly every week I find myself having to remind a receptionist or assistant to reconsider a response to a parent. “What would you have said if your daughter had been the patient?” I think it was Pogo the comic-strip possum who said, “We have met the enemy and he is us.” Customer service boils down to accepting the reality that we are all in this together and so we might as well treat each other as equals.

The second troubling concern that surfaced as I waited for the anecdote swapping to end was that this event had seemed to unroof a festering sore of dissatisfied physicians. Maybe I am reading more into this alcohol-enabled complaint session than I should. But, I have read somewhere that when older physicians are asked if they would encourage young people to enter medicine, many of them reply that they wouldn't.

What is it about being a physician in the new millennium that is making us such an unhappy bunch? Certainly, hassles with third-party payers and the ever-present threat of a malpractice suit can put a few dark clouds in your sky. But listening to these doctors, it sounds as though the day-in and day-out interaction with patients, or certainly with parents, might be a significant source of discontent among some of them.

I've always figured that medicine—and definitely pediatrics—is a people business. And we the people are a quirky sort. We do dumb things with great frequency, and from time to time even the most saintly among us behave inconsiderately. Failure to accept those basic facts of life might be at the root of some of our discontent.

And there might be a good argument for requiring all medical students to have a real job, such as waiting tables, before they start their formal medical education. It might just cut down on the whining.

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