Bouquets? None! Yet I thank my stars. There were no brickbats either, from dissatisfied patients who I may have been rude to, or whose cases I may have misdiagnosed or whose expectations I did not live up to. A doctor’s life has its share of crosses, as Blaise Pascal eloquently put it, “Grandezas e misérias da nossa profissão” (Moments of grandeur and misery in our profession)…
I have time and again re-read the book Successful Medical Practice: Winning Strategies for Doctors by Dr Aniruddha Malpani, a gold medalist and consultant IVF specialist who practices with his wife, Dr Anjali Malpani in Mumbai. The book is very special for medical practitioners worldwide. Written with punch, precision and clarity, I can’t help quoting passages verbatim as I go on.
But, may I ask candidly before I proceed, what do we mean by success in medicine? Is it making a lot of money, the ability to purchase a new Mercedes car every year, or be elected President of the Medical Association? Despite temptations for material things, we can declare ourselves successful only if we accept that success is that exhilarating feeling that comes from having discharged our duties well, toiled with honesty and been caring and compassionate to our patients, no matter if we fail at times.
A hundred years ago, when life was much simpler, the successful doctor was said to require just three things: a top hat to give him authority, a paunch to give him dignity, and piles to give him an anxious expression.
Today the world is different. For a doctor to run a successful practice, he needs to be i) a clinician with polished skills, ii) an academician who is a constant learner, iii) a manager who understands the business of running a clinic, iv) a CEO who can motivate his staff, v) a family provider who spends quality time with his family and vi) a self caretaker who knows how to look after himself and his personal needs.
“Running a successful practice can be hard work. While medicine can be a very fulfilling profession, one out of three doctors reports that medical practice leaves them dissatisfied because they have too little time for themselves or their families. Doctors suffer from depression four times as often as the general population and many doctors hate their jobs – and their patients too! In fact, many physicians are now quitting practice because of too much work, too much hassle, too much competition, too much despair, too little reimbursement.”
In the past when doctors met for clinical meetings they would talk merrily about the interesting patients they had helped to treat and cure. These days they talk about financial stresses, job pressures, bureaucratic hassles and red tape. Many are increasingly toying with the idea of changing careers, while others are burning out in their mid-forties. Looks like all the joy of practicing medicine has gone.
So what do we do to find anew joy in medicine? First and foremost, we need to find meaning in our lives. Physicians are fortunate to work in a job that can provide so much satisfaction. We are privileged to take care of patients and learn so much from them. It is amazing to see how patients bare their hearts to us and make us privy to their innermost confidences. “Like no one else doctors are allowed to get a ringside view of the human drama, suffering, courage, life and death – the stuff of which life is made. We are given the rare chance to plumb the depths of the human soul. Our work also lends us to contemplation and introspection — allowing us insights which few other people are privileged to have.”
More important, our patients teach us to live and die. While this can dishearten a few, others find here an opportunity to reinvigorate and rejuvenate themselves. Watching patients die reminds us of our own mortality, so that we can thus remember to live each day well. Why have doctors been placed into this world? To help others, to make the world a better place to live in. Ancient vaidyas considered themselves to be very fortunate, for the opportunity to fulfill the three aims of life: dharma (religious gain by relieving the suffering of patients), artha (material gain to help both ends meet), and kama (personal satisfaction for curing those whom they love and respect).
Medicine truly has many crosses. But it is a vocation par excellence, a wonderful way of living our lives to the full. Medicine, like few other professions, brings in a spiritual awareness and the realization that death is not the end. And this very spirituality allows us to get in touch with our own humanity and finiteness.
When we as doctors feel down and out, let’s pause for a while, listen to what our conscience commands and despite odds go on fulfilling our noble task with ever more zeal and determination.
(Dr. Francisco Colaço is a senior consulting physician, pioneer of Echocardiography in Goa and column writer)
