You may see me as a physician, but I see myself as an educator. I have been doing it for over 20 years, lecturing all the country, and I’ve received several teaching awards. In fact, it’s a personal source of pride. Of course, I am dedicated to patient care and I really love my work. But teaching is my passion. If you were to ask me how I approach my interactions with patients, it would be with education as my primary goal. I consider the pathophysiology and how I can educate my patients to understand the treatment and empower them to take control. One of the greatest joys of being a teacher is developing long-term relationships. Over the years I have trained hundreds of residents and medical students, and have enjoyed watching them mature into their careers.
In the last few years, I have noticed a very worrisome trend. The physicians that I had trained are coming back to me with some troubling complaints. Many of them were now looking at their 2nd or 3rd job only a few years out of finishing training. Many of them are completely turned off by medical practice. Several of them are considering a change in career, or leaving medicine altogether. Many have the syndrome called “burnout”. I could not understand! I love my career and love taking care of patients. How could the same doctors who showed the same passion now have such change of heart?
As I dealt into the problems deeper with the physicians I came across a consistent trend. They all felt betrayed by the contract process. They realized there are under-compensated, often had poor benefit packages compared to their peers, and were expected to generate more productivity for a lesser bonus. Before starting their first job they had no education regarding contracts, market value reports, and negotiation techniques. It was all a complete mystery!
Further investigation revealed that they also did poorly in developing their careers. They did not understand the role of networking or how to work effectively with an organizational structure to achieve their goals. They felt underappreciated and their progress was stymied. The hadad poor conflict management skills-tending to “back down” or “blow up” and rarely saw any problem come to a meaningful resolution. They complained of always being on the losing end of conflict and group decisions. The inability to get their ideas heard had led to depression and disappointment in medical practice.
The cause was obvious; we had done a poor job teaching them the professional skills they needed to survive. We had spent years teaching them about the Krebs cycle, how to manage sepsis, and that insulin makes the sugar go down. The one thing we never taught them is how to manage their medical careers. They never learned how to interview, negotiate, interpret contracts, and to deal with conflict or office politics. They were unable to make the financial decisions required as well.
I had gained a lot of this knowledge over the years, some of it the hard way by making costly mistakes. I had taken several courses and seminars and had personal experience in negotiating contracts, teaching conflict management, and the successful use of organization structures to effectively achieve goals. Starting gradually, I began to teach residents and students medical professional skills. Over time, the word got out and I became very busy responding to requests. Not only was I being approached by students and residents but also by attending physicians! Many of them had over 15 or 20 years of experience but still felt uncomfortable ins some very basic matters.
As my former students fanned out throughout the country, I began to be approached by physicians outside of my immediate institution. The lack of preparation for the “real world of medicine” was an eye-opener. Realizing the tremendous need for negotiation and medical professional business skills training, a movement was born to prepare the upcoming generation of physicians. This was as important as evidence based medicine or any other educational initiative. The other initiatives were designed to protect patients. My initiative protected physicians-assisting the next generation of healthcare providers to practice without burnout and truly succeed in their medical careers.
I would continue advocating for patients, like I had done for my entire career. Only now, I would also start advocating for physicians.
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