Personal Look at 20 Years of Doctoring (Part 2)

“. . . For the secret of the care of the patient is in caring for the patient.”

“These words, burned indelibly into the minds of generations of medical students, closed a lecture given by Francis W. Peabody to Harvard students on October 21, 1925” (N Engl J Med 1993; 328:817-818).

Still Striving to Be the Best

Yesterday, I noted how difficult it is to ‘get away from it all.’ Both technology and empathy are to blame.  The flip side of the message is that I still want to be the best.

In medical school I was eager to read so many books that discussed what it meant to be a physician.  Now having worked as a physician for 20 years I have my own thoughts.  On an abstract level, it is easy to say that you want to be the best physician. To accomplish the task, you work really hard, you read everything you can, you listen intently, and you set aside enough time to think carefully.

Yet, that still is not enough.  As a practical matter, it is not so easy to be the best at anything.  The biggest problem is that there are other people who are really terrific. How can I be the best when there is always someone smarter, funnier, and more empathetic?   In medical school, I was given a few pieces of advice:

‘After 5 years of practice, all of your patients will love you….those that don’t will see someone else.’


‘There are three A’s to being a great physician.  Availability, affability, and ability.  Since most people have difficulty judging ability, you will probably be judged more on the first two.’

Perhaps, the logical conclusion is that I might be the best physician for some patients and not for others.  At this point, I will have to be content with knowing that I am still trying to be as good as I can be.

“When you reach for the stars, you may not quite get one, but you won’t come up with a handful of mud either.” Leo Burnett

If you are a reading this blog, what are you doing to be the best?



5 thoughts on “Personal Look at 20 Years of Doctoring (Part 2)

  1. Great couple of reflexive posts. What am I doing to be the best? I gave up trying to be the best a long time ago. Best is such a contested term, i.e., different people have different measures depending on their own knowledge, as you reflect. As an IBD patient I try to take responsibility to make informed choices about my treatment and look to my doctor for his clinical expertise, as well as reading Cochrane and pubmed. I also try NOT to contact my doctor out of hours even though he gave me his number. When I do I know I am taking him away from his life and apologise profusely.

    As an architect, soon to have a doctorate, I know my strengths and weaknesses in design. Ironically, the doctorate has shown how my own body of knowledge is quite small when I thought it was good. I’m doing my best to not let that freak me out, and to work with my clients (the ones who choose me) to the best of my knowledge and capabilities at that time.

    If you are asking reflexive questions about your capabilities, you are probably good at your job.

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