The Myth of being a Good Doctor

 All knowledge attains its ethical value and its human significance
only by the human sense in which it is employed. Only a good man can be a great physician. Hermann Nothnagel (1841 – 1905)

Working as a doctor in private practice is demanding. It is a system that barely has enough room to allow for holidays, let alone sick leave. Sometimes I wonder why any sane person on Earth would do this job for anything other than the right reason?

For the last 12 years working as a private consultant, I have never been absent from work a single day, except for a few short holiday trips with my family. I still remember the days when I was doing dialysis rounds with a high fever, and the day when I thought I was sicker than my clinic patients when I came down with severe cellulitis. Being a good doctor is always my dream, but is this a realistic dream?

Doctors are Fallible Humans too

Almost all doctors try to treat their patients wholeheartedly , sometimes neglecting their own family members and themselves. I once believed that if I have tried my best treating my patients with all the available information and knowledge, I would be considered a good doctor , however, this presupposition does not hold water anymore .

Doctors are fallible humans who make wrong decisions infrequently. Sometimes, certain treatments given in good faith turn terribly wrong due to unforeseen circumstances , is this kind of mistake forgivable? We swear and stand by the Hippocratic Oath our whole life – do no harm to our patients – even though sometimes ignoring our own health and well- being. Unfortunately, the doctor-patient relationship has changed drastically over the years. It was a simple consensual relationship that built on trust , loyalty, and mutual respect. However, this sacred relationship can turn sore when some complications happen during treatment.

Complications do happen in daily clinical practice . Regrettably , doctors are always being portrayed as the evil party when things go wrong, no matter how hard we try.

Medicine is now a business

Medicine is a practice that combines science and art. Often, some diseases behave in a way that no one can predict its prognosis, therefore opinions of two experts may be different but may still be correct. Nowadays, not only are patients arguing with us based on half truths they find from Google and Facebook, but our decisions are also being questioned by a nameless, underqualified clerk from insurance companies.

I used to believe if I treated patients according to consensus and medical evidence, I would be considered a good doctor. Unfortunately, modern medicine has become the most lucrative and profitable business in the world over the past few decades. Every industry wants a share of this lucrative pie, and treatments are no longer given in good faith. Instead they are dictated by insurance companies, hospitals and unscrupulous clinicians who prefer to provide alternative treatments at inflated costs.

Patients always turn to alternative and unproven treatment before eventually turning up at our doorstep when they have exhausted their alternative treatments or when they are critically ill. They prefer half baked medical advice sourced from social media rather than professional advice. Advertisements in Instagram and Facebook have become their number one source of medical information.

Aren’t we supposed to be honest?

I once believed being a doctor is a noble profession. We should set good examples by upholding the highest standards of the human race- honesty, humility , and hard work. Unfortunately patients frequently ask us to lie about their medical history. More often than not, we are asked to overlook their past medical history so that their insurance can be approved.

This issue is often compounded by the fact that the insurance agent did not disclose patients’ prior medical history in an attempt to reduce premium or to help their clients so that their policies can be approved.

Patients often pay their premium religiously for years and when their hospitalization bills are not reimbursed, doctors are often labelled by patients and insurance agents as ” someone who do not know how to write insurance claim properly!”

“If I was trained to cheat in order to get your hospital bill reimbursed, you should be worried about my personality!” I tell my patient, ” Because I might be cheating you too about your illness!”

Am I the only ONE?

Doctors are supposedly to be selfless, they should care more for their patients, neglecting their own spouses, children or even themselves. You can forget the dates of your children’s birthday, your marriage anniversary, your mother’s doctor appointment but you shouldn’t forget your patient’s medication dosage, his next appointment date, date for his operation or procedure.

I once believed that by being a good doctor, I would be appreciated by patients. A good doctor’s ego keeps him in a state of constant denial- thinking that he is the most knowledgeable and irreplaceable. Unfortunately, a good doctor will finally realise his patients are not his diehard followers at the end of the day.

I am certainly not the ONLY good doctor for my patients. If I were to die next week, my hospital will get a new doctor easily to replace me within days and my old patients will switch to the new doctor the following appointment. No patient ever stopped getting treatment because his or her favourite doctor died. In fact, as a good person, you are only irreplaceable in your family as a good son/daughter, as a good husband/wife or as a good father/mother!

Conclusion

Yes, being a doctor is hard, but being a good doctor is almost impossible. As I said earlier, practising medicine is no more a simple relationship between doctor and patient but rather a complex process involving multiple parties with different intentions.

Doctors have to wake up eventually from the delusion that they are the almighty, irreplaceable healer because they are not! There is no number one doctor in town, your patients will turn to another doctor when you are sick or dead no matter how smart you think you are : a simple fact that very few of us refuse to acknowledge when we are alive but only find out when we are in heaven ( ? or hell)!