Let’s Connect
From the
President
JAMES Patrick Murphy, MD, MMM
GLMS President
[email protected]
Emerge again
T
his child is curious; always getting
into things, not in a bad way, but in
a joyful way. This child can grasp
complexities with relative ease, can understand the roundness of the world, gravity,
and that anything divided by zero is infinity.
At some point this child’s gaze turns earthward enough to learn the system. Grades,
awards, and accolades come in quanta. Pride
arrives. There will be more schooling. A
student emerges.
This student learns, expresses, yearns,
and dreams. And at some point along the
didactic journey this student catches a
glimpse of a destination. There is no turning
back. Medical school happens. An explorer
emerges.
Running toward the edge, then leaping,
this explorer feels the rush of new air, the
exhilaration of wonder, and the anticipation
of plunging into the water rapidly rising
from below. This baptism requires boundaries and deference to practicality. Residency
training is completed. A physician emerges.
is tagged, branded, and blended into the
health care provider herd. A demoralized
physician emerges.
The demoralization of our physicians has
consequences. In 2007 a survey found that
57 percent of physicians would not recommend that their children pursue a career in
medicine. Five years later, that number had
grown to a staggering 90 percent. Moreover,
at least half of physicians surveyed said,
given a second chance, they would not
choose medicine again. Factors include:
exhaustive electronic data requirements;
lack of practice autonomy; devalued physician input for developing system protocols;
increasing demands to see more patients in
less time with fewer resources; rising tides of
unclear regulations; diminishing influence,
fairness and respect among payers; and most
disturbing, the physician’s perception that
one’s ability to provide high quality care is
on an unalterable downward spiral.
From the moment this physician enters
the wormhole of a medical education, the
system seeks to constrain, program, harness,
package, and automate this free thinker - all
in the name of value-based quality. There’s
no blame. It’s what the system is designed
to do.
We don’t start out feeling this way. In
August 1981, on my first day of medical
school, one professor welcomed us with
the surprising declaration that a portion
of our class would graduate but never practice medicine. “Regardless,” he said from
the podium, “you will have been afforded
a medical school education, perhaps the
greatest learning experience our society can
offer, unveiling the mystery of human life
as few will ever understand it. That will be
your gift. What you do with it will be your
responsibility.”
However, a creative mind wilts under the
weight of endless regulations. A compassionate soul suffocates in the digital coils
of impersonal informatics. A joyful heart
fatigues fighting the payer’s resistance to a
thoughtful plan of care. And this physician
Anyone who has been faithful to this
responsibility knows the road is not easy
- important things rarely are - and that the
road provides ample shares of both elation
and devastation. When one’s mission is to
alleviate suffering, suffering can leave its
Emerges to an environment ruled by the
forces of conformity.
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mark. Then change occurs.
But to what extent do we change?
A recent discovery provided me with a
clue. While going through some old boxes
I came across a copy of my medical school
application. Seeing those yellowed pages,
rekindled a memory of that late night in the
summer of 1980, sitting alone in my parents’
basement, filling out the forms, typing away
on my vintage Royal manual typewriter. As I
read the “personal comments section,” composed by my twenty-year-old-self nearly
34 years ago, I grinned and wondered how
I’d ever gotten accepted. Included among
the six highly emotive paragraphs was this
passage bursting with confidence, naïveté
and honesty:
Something is calling me. People, they
need me. Medicine, it needs me. Not so
much because of the condition of medicine
in particular, but more so because every
profession does indeed need me - or else
people like me.
And people like you.
There is a shortage in our profession a shortage of practical dreamers who can
remain child,