The Making of the Ideal Physician

Professionalism Criteria ♦ The ideal professional is respected by all. This professional is the ultimate role model because he/she always does the right thing and cares about people. Achieving respect should be one of your primary goals. This includes being respected by professionals from other institutions. How many full professors or chairs of large group practices do you know who are jerks? Do you still respect them? ♦ This ideal physician always practices the Platinum Rule of Medicine: Treat every patient like you would want a member of your family treated. ♦ Does this individual represent your group? ♦ Would you want him/her as your physician? ♦ Is the physician a team player? Teamwork imbues loyalty and pride in your institution. Those who lack pride and dedication will become apathetic, lose their work ethic, and do the least amount of work and social interaction possible. This is contagious. ♦ If you work in an academic medical center, your ultimate career goal should be to become a full professor. Seeing patients may be your primary interest, but there’s no reason why you also can’t write papers and teach to work toward qualifying for academic promotion. If you write two peer-reviewed papers a year, this would result in sixty papers in thirty years. You should work with a resident or two on most papers. ♦ If you are the attending on hospital service, you are the physician of record. You must be sure that the patient is getting the best possible care. After rounds are completed, consider going back to the patient without the house staff (or with just one resident) to clarify some matters. This is extremely important if things are not going as well as expected. It is just not right to make the patient wait twenty-four more hours for your next visit. This doesn’t undermine the experience of the residents; on the contrary, it will teach them a lot. You are the role model! Be sure the patient has the written names of all the physicians who are taking care of him/her. These are some traits of the ideal professional: ♦ Trustworthy and demonstrates high integrity. ♦ Known for having common sense. ♦ Has a passion for mentoring and considers mentoring a professional obligation. ♦ Has no hidden agendas, is not self-serving, and is transparent in his/her professionalism. ♦ Sees patients and enjoys this part of the job, even if he/she also is a researcher. Goes the extra mile, e.g., sees patients not on the schedule. This also would include taking a call from a referring physician and working a patient in within a day or two when appropriate. The good physician treats the disease; the great physician treats the patient who has the disease. —Sir William Osler ♦ Keeps a tickler file of patients with undiagnosed problems or who are due back at a definitive time while awaiting test results. The physician’s clinical assistant will check this file daily. A call from you is immensely valuable and will help your patient while he/she is healing. The ideal physician never leaves a voice mail or sends an email when he/she has to tell a patient about abnormal test results. This physician will try again to reach the patient or take the patient’s return call right away. ♦ Relates well to referring physicians (see Chapter 10 on Qualities of a Chairperson in an Academic Medical Center or Private Practice Medical Center). ♦ Is very appreciative of the value of teaching—sees it as an obligation and makes it a high priority. ♦ Is always a gentleman or lady. Virtuous Qualities of the Ideal Physician ● Character is what you are—it is your reputation, which takes years to build but can be lost in minutes. Building your reputation is a continuous journey, not a destination. It’s always doing the right thing. It’s looking in the mirror in the morning and asking, “Is the image I’m seeing someone I can greatly respect at the end of the day?” The ideal physician never gossips. The physician with character always remembers who he/she is working for—the patient! ● Integrity is a firm adherence to a code of moral values. It is what you do when you don’t know that someone may be watching. It is an implicit obedience to the dictates of your conscience. Integrity is what you do every day, whereas character is a long-term quality—your reputation. An example of integrity is doing something good while knowing that no one will ever know that you did it. ● Humility is the ability to see yourself, including your faults, from a distance. The ideal physician is confident (but not cocky), self-effacing, grateful, and able to respect himself/herself. ● Lack of arrogance (humility). There is no such thing as an arrogant, compassionate physician. The arrogant physician is easily angered and brings this to work with him (we’ve rarely seen arrogant women). The arrogant physician exudes a professional detachment. ● Trustworthiness. Honesty. To many patients, trust is more important than compassion, integrity, and other virtues. Trust is sacred to our profession, but we are rapidly losing the public’s trust, mostly as a result of the commercialization of medicine. The patient’s trust in his/her physician is an unquestioning belief that the physician will do what is best for him/her without compromise. The ideal physician is a partner with his/her patients. This physician practices the Platinum Rule of Medicine. Trust is a two-way street. The physician trusts the patient to be compliant. The satisfaction that the physician and the patient have in each other greatly relates to their mutual trust. Satisfaction is an outcome measure of mutual trust: a perception that represents past experiences and fulfillment of a patient’s expectations. This is recognized as good continuity of care, which is highly valued by the patient.