R-E-S-P-E-C-T

In a recent Wall Street Journal essay, Dr. Sanjeep Jauhar quotes a doctor who seems to sum up the Rodney Dangerfield state of the American Medical Profession,”I get too little respect from patients, physician colleagues, and administrators, despite good clinical judgment, hard work, and compassion for my patients.”

In the new era of population based metric driven health care it is easy to forget the doctor. Professional morale is low and the data suggests that this is more than a few isolated doctors.

According to a 2012 Survey of America’s Physicians: Practice Patterns and Perspectives Survey conducted on behalf of The Physicians Foundation:

• Over 84 percent of physicians agree that the medical profession is in decline.
• The majority of physicians – 57.9 percent — would not recommend medicine as a career to their children or other young people.

• Over 60 percent of physicians would retire today if they had the means.
• Close to 92 percent of physicians are unsure where the health system will be or how they will fit into it three to five years from now.

Dr. Jauhar touches on the most serious problem- A dispirited workforce effects the quality of care:

“Perhaps the most serious downside, however, is that unhappy doctors make for unhappy patients. Patients today are increasingly disenchanted with a medical system that is often indifferent to their needs. People used to talk about “my doctor.” Now, in a given year, Medicare patients see on average two different primary care physicians and five specialists working in four separate practices. For many of us, it is rare to find a primary physician who can remember us from visit to visit, let alone come to know us in depth or with any meaning or relevancy.”

And then there is also impact on doctors themselves.

Dr. Pranay Sinha, a resident physician writing in an op-ed in the New York Times, tries to understand the high rate of suicide among physicians. He writes:

“While acute stress, social isolation, pre-existing mental illness and substance abuse may be obvious factors to consider, we must also ask if there are aspects of medical culture that might push troubled residents beyond their reserves of emotional resilience.”

What is true for residents, might unfortunately also be true for attendings, who get neither the hours protection (working too many hours) or oversight of residents. A review on suicide mortality in medical doctors concluded that “the suicide rates among doctors were higher than those in the general population and among other academic occupational groups.”

Doctors are not machines, nor would we want such a thing. Respect is not simply about a pat on the back, it is about creating a professional space in which doctors can do their jobs in the right way and where, along with the other providers and patients, they can share in the honor of their profession.

Respect is as important for doctors as it is for all people and all types of professions. But it is not just about the doctors. For if doctors feel disrespected or have low morale, this impacts patient care and how patients feel about their experience. Or putting it another way- respect for doctors is good medicine to practice not only for the doctors, but also for patients and the hospitals and health systems doctors work in and patients go to. And that point- the value of creating methods for and the need to show respect to doctors- is something that smart administrators would be wise to acknowledge and do.