On Doctor Personalities

The Doctor Factor (washingtonpost.com)
Several have held forth about this recent screed in the Washington Post. I have read it several times and have not been filled with warmth or compassion for the writer.

The man is a doctor. This is the least-examined chapter of his career. But suddenly it all makes sense: Where else but in medicine do you find men and women who never admit a mistake? Who talk more than they listen, and feel entitled to withhold crucial information? Whose lack of tact in matters of life and death might disqualify them for any other field?

Uh, journalism?

Try this exercise: watch a televised piece, or read an article about something you know pretty well, and find all the areas where the reporter left things out, or glossed over big parts, to get to the story they want to tell. Or, just recall the last 20 times you’ve watched some televised fool stick a microphone in the families’ face and ask “..and how do you feel (about this horrible tragedy)”, which in a just world would be followed by a beating.

I have met some really incredible jerks in my practice of medicine, and have to deal with a few nearly every day. Many, many more are friendly both to colleagues and their patients. It’s human nature to recall the unpleasant one out of the sea of thousands, it’s pettyness to paint everyone based on the worst of any group.

The author here has engaged in some pettyness of her own, slamming doctors. It’s fun, and easy to do. Doesn’t make it right, though.

And, question to Andrew Sullivan: How is medicine an “undemocratic profession”? It’s democracy in action: people who are highly motivated and smart with good grades get into medical school. Those who apply themselves get the best residencies, then get to work 80 hour weeks for years to learn a profession, which requires constant education and recertification. All this to be Doctor in the most regulated profession on earth. The vast majority laws which I must practice under are written by people who don’t practice medicine, enforced by non-physicians and openly reported on. That’s democracy.


  1. John Anderson says:

    I agree that the writer went overboard in describing the majority of doctors this way, but she raises a point about Dean specifically: could his inability to admit a changed view [not going from”wrong” to “correct” per se, but changing as a result of more knowledge/experience/reflection] have been an existing trait made [inadvertently] worse by training? And can he overcome this seemingly knee-jerk reaction?

    I used to dismiss out-of-hand any offer of spinach as not something I could enjoy, but then I tried Eggs Rockefeller and changed my mind. Now, I could use a Dean approach, because I actually still cannot enjoy spinach – I am allergic to greens (hey, I was drunk at the time and the hostess was single, smart, and good-looking) – but my pre-conception that a taste for spinach must be acquired (like beer…) changed and I admit it.

  2. I specifically disagree that medical education has made doctors jerks, or is responsible for Mr. Dean’s inexplicable ability to admit changes in his opinions. This presumes those entering medical school are devoid of personality are are assigned/leard one while in training. There are grains of truth to this, as to any other profession (‘fighter pilot mentality’ springs to mind), but the idea behind it is absurd. There are plenty of people in unskilled jobs that are jerks, and I doubt it was their training that did it.

    I object to Ethics training for the same reason. The idea that we are all ethical neophytes without any right/wrong compass, and that an hour of ethics training will help medicine in general and docs in particular to ‘see the light’ is sophmoric. If you’re a crook/liar/whatever, no amount of clasroom training will fix that, but 99.9% of us who are not ethically bereft get the classes anyway.

    Also, this whole line of thought gives the impression that Dr. Dean walked out of his clinic and went to register for the presidential race. That leaves out the fact that he was the Governor of a state, which must give a huge education in politics; whether he learned anything from that is another matter.

    It’s not the training, it’s the person.

  3. Some writers just write for ratings these days. I wonder if that piece was meant to be inflammatory.

    Anyway, your last paragraph was exceptionally interesting. You make a very very good point. Whenever hospital policy is changed, nurses everywhere say, “Oh, there goes someone justifying their job in the government again.”

  4. As one of the ones who started this ?dog pile? (do kids still do that? Probably not PC these days) I?ll weigh in with a few comments about doctors.

    Docs are amazing creatures that defy most definitions. They overcome incredible challenges just to get to the state where us lesser mortals can poke fun at them.

    I?m sure the profession?s allure attracts more than its share of jerks and the military, as GD can attest, attracts even greater numbers. Frank Burns wasn?t based on a fictitious person.

    That said, even jerks can be great doctors and I only ran across one Frank Burns in my life.

    Early in my military career I toyed with the idea of become a physician assistant; two thing dissuaded me. One, my wife (an Air Force nurse) told me that I didn?t like people well enough (true) but the clincher was number two. I had to follow a few doctors around for about a month. ? Well, five days but it SEEMED like a month!

    Rounds, consultations, more rounds, middle of the nights rounds, early morning rounds, talking and listening to really boring people (see one, above) reading and re-reading stuff. Pharmaceutical, etc. I could go on, but what impressed me about docs was the dedication and the intensity and the attention to really boring people (see one, above)

    So, I gave up my medical aspirations and became a criminal investigator (see one, above)

    But I still see that level of dedication and am grateful for that. I?ll refrain from cheap shots for at least a month (well, at least a week)

    But the point that started all this is still valid, Howard Dean is a nutter.

  5. Jim, thanks again for the excellents comments. You need a blog of your own, though I’m very glad to have you commenting here!

    And your ending sentence embraces my thoughts succinctly.

  6. Yes, there are doctors that are bad, but many more these days have surpassed the “old school” methedology of training and are becoming much more personable and understanding with their patients. The transition is taking place, and the kinder, gentler (LOL) Doctor is emerging. One that listens to his/her patients rather than treating them like they know absolutely nothing and decide your condition before you even tell them your symptoms. Of course there will always be those that think they are above the rest of us, but we’ll just have to keep working to take them down a notch. But I will say that if I’m hurt and need help in a hurry, thank God for Western Medicine!

  7. Why would you “work to take them down a notch”? Why not just say, “again, please, this time in English?”. It’s worked on me, in my formative years.