Brain Power and Relationships
November 10th, 2009 by Candice Chen (email author)Last month I wrote about our country’s specialty focused culture and last week as I listened to a medical student describe his cardiology rotation - how the cardiologist showed off his tools as if they were toys – and I watched as the medical student’s eyes lit up describing his experience, I realized it’s time to write about the specialty culture of medical education. And while it would be easy to write about how medical schools and teaching hospitals, due to funding streams and priorities, have created a specialty focused culture in which medical students are subjected to comments like, “You’re too smart to go into primary care,” I’d like to talk about the need for primary care doctors to do a better job marketing themselves.
First, I’d like to address the issue of being “too smart to go into primary care.” To get at this issue, I think it’s worthwhile to examine why physicians spend so long in training and studying things like pathophysiology or pharmacology. Ultimately, what this training does is build brain power. The most difficult thing that a physician does is to take a constellation of patients’ symptoms, ask the critical questions, order the key tests to figure out what the problem is and treat the patient using the best interventions. This is at the core of a primary care physician’s job. Procedures can be done by technicians, but accurate diagnosis and appropriate treatment are the most important and difficult parts of any physician’s job.
The second piece at the core of being a primary care physician is relationships. Patients benefit from this relationship by receiving more consistent, coordinated and preventative care. But as physicians, we also benefit. Patients allow us into their lives, into their families, and whether we experience moments of heartbreak or moments of joy, it’s a privilege and a rare opportunity in society. As a pediatrician, I look at children, remember when I held them as babies and can’t believe that they’re telling me about what they’re doing in school. I get to share in the joy of my teenagers when they talk about which colleges they’re interested in. And sometimes, all I can do is put my arm around a parent when I have bad news for them and assure them that we’ll move forward as partners.
Brain power and relationships – this is what being a primary care doctor is all about. And this is what we need to help medical students see and understand. As I mentioned last month, there are a number of factors that affect medical students’ career decisions – payment, practice, culture – but if we can do a better job showing medical students the joys of primary care, then we will be better poised to take advantage of other reforms. And ultimately we’ll get the brightest and most compassionate students entering primary care.