Doctors are not evil, but it’s easy for patients, their families, the general public — and physicians themselves — to see doctors as bad, if not evil.
The solution? Don’t let the mechanics of medical practice, the daily irritations of regulatory compliance, legal liability, business practices, and the alphabet soup of health information technology, and health care reform get in the way.
“If doctors are not evil, we can still be demoralized and disenfranchised as leaders in health care,” cautioned C. O. Granai, Jr., MD, FACOG, director of the Program in Women’s Oncology and associate professor at Brown University. “Doctors are increasingly disenfranchised. It takes away from your passion and your heart for medicine.”
Dr. Granai wrapped up the Saturday morning’s Presidential Program with the Jim and Midge Breeden Lecture, “The Good Fight.” The Good Fight is an amorphous concept, he cautioned, but it is a concept that all good ob-gyns understand. Ask yourself what brought you to medicine in the first place and fighting for that same level of commitment and passion, he said.
For many physicians, recovering the passion and commitment to medicine starts with a seemingly simple question: What would you want done for your own loved one in this situation? At Brown, that question led the Program in Women’s Oncology to create two parallel lists of goals, a list of the scientific values and a list of the human values of high quality cancer care.
The scientific values are a given in any good clinical setting, Dr. Granai said. The human values — concepts such as time matters and quality matters — are harder to define and even harder to instill.
“Health care has changed, some for the better and some for the worse,” he said. “It is the latter that makes it tough to be a doctor. Our role is to advocate for the chance for people to live as long and as well as possible. We can help people connect with their own meaning. We can help people fight for abiding love and kindness. That is the good fight. If we abandon that advocacy role, we approach being evil.”
Health care is a living, growing, evolving organism, Dr. Granai said. And like every organism, health care has both a phenotype and a genotype. The phenotype changes in response to external conditions. Health care is changing in response to scientific advances, product development, social expectations, business and financial pressures, regulatory adjustments and more, just as it has always changed.
“If the phenotype of health care will always be in a state of change, the genotype of caring will never change,” he said. “Caring is worth being committed to. When we realign with our original commitment to care for and about people, we can undemoralize ourselves and we become better doctors. No, we can’t be Dr. Superman and do it all. But we can be Dr. I-Can-Try. That is our good fight and we can fight it every day of our lives.”