Viewpoint: A tale of three surgeons

October 23, 2009

It may be time in the profession to value quality over quantity.

When I was told that Dr. Abbot was on call for the group, I asked for Devins anyway. We caught up to him at his son's soccer game, and when I started to explain the case he said, "Call Abbot. She's on call." And he hung up.

I called Abbot, not happily. She handled the patient's uncomplicated appendectomy that night. The man went home in the morning and later thanked me for "choosing" Dr. Abbot.

The first of them, Dr. Devins, had made a clear choice: Make time for work, make time for family.

Dr. Stein, the now-retired senior partner, would have responded differently. If I had caught him at a family event, he would have said, "Get the patient admitted and prepped. I'll be there in 30 minutes." To him, work was more important.

My father, a surgeon another generation prior, would have done the procedure too, but it would not have been necessary to call him. More likely, he was already in the hospital, performing another procedure or two. My father's choice: We are doctors. We work.

I recall how amused my father was when I started my one-night-on, two-nights-off internship. As a surgical intern he had been on call 28 days of the month. I was equally amused when I heard that the crops of residents that followed me were limited to only 60 hours a week, then 50, and now even less.

And as I continue my 12- to 14-hour days, plus weekends in the nursing home, I ponder my younger colleagues who opt for four-day workweeks.

They don't put in the hours that we did, and they certainly aren't working like the giants who preceded us both. Probably none of them will ever fall asleep on a gurney in a dark hospital hallway or nod off at a red light after 24 hours on duty. What's wrong with these guys?

Increasingly I say to myself that perhaps there is nothing wrong with them. After generations of overworked and overstressed physicians, common sense finally may have arrived at the hospital doorstep.

Perhaps it is time for our profession to value quality over quantity, time to consider that working so much does not make us better physicians or better people. Our younger colleagues may never be rich, but they may have richer lives: more meaningful relationships with spouses and children, better physical and mental health, more happiness to share with others. They may be better physicians.

So work less if you choose, my young colleagues: Have other interests, nurture your families. But when you do work, always work hard and always work well, work with zeal and compassion. And love it. Love it the way I do, the way Dr. Stein did, and the way my father did. That will be fine.

And go to more soccer games.

Richard Waltman, MD, is a family physician in Tacoma, Washington. Send your feedback to meletters@advanstar.com
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