I’m a doer. I like being a doctor who can fix things, whether it is treating an ear infection, suturing a laceration, or managing a patient through DKA. But I don’t just like to “do” – I like to serve. I enjoy home visits. I enjoy going to the nursing home. And I particularly enjoy volunteering at our local free clinic for the uninsured. With the cost of healthcare in the USA steadily increasing, I enjoy being able to be a part of serving those who are left out.
I also like to be a thinker, and feel it is important for us as doctors to THINK about why we do what we do. So, when I’ve had the opportunity to speak about the opportunities and challenges in caring for the uninsured, I’ve been a bit flummoxed when listeners have told me they want more on “how to” and less on the ethics, principles, and ideas behind service and care for the poor. And, having had that feedback, I actually felt a bit vindicated to see the program for a recent conference on health care for the poor included a whole track on issues of service, professionalism, and the doctor’s identity. “At last!” I thought, “more recognition for the issues of identity, and not just ‘getting the job done!’”
However, I’ve also been reminded recently, that there is still more to medicine than thoughtful service – doctoring is more than just thinking and doing. Several encounters, with students, patients, and colleagues, both at home an abroad, have reminded me yet again of the foundational importance of the relationship. Medicine is nothing, if we lose the human, “I-thou”, person-to-person connection with our patients.
As doctors, it’s easy for us to see the need for our service. But for our service to make a difference, we also need to think carefully and reflectively about what we do. However, for our care to have VALUE, for it to be HUMAN medicine, we need to pay as much, or probably more, attention to the relationships with our patients and our colleagues.
Relating, thinking, and doing – each is a vital piece of medicine, and put together they make for even better doctoring.