Physician = God Complex?

By Dr. Anthony Youn

"I Am God!" proclaimed Alec Baldwin’s Dr. Jed Hill in the 1993 movie Malice. When he revealed his Doctor-God complex, most non-medical viewers were shocked. Doctors and nurses... not so much.

Why do some doctors think they are on par with God?

One night as a third year medical student I was assigned to work with a grizzled, veteran Ob-Gyn doctor for a night of call. At 2 am I went up to the doctor and asked the typical medical student question, "Is there anything I can help you with?" In front of the entire nursing staff he set his face 6 inches from mine, pointed his finger at my face, and said, "There is absolutely nothing, I repeat, nothing you can and ever will be able to help me with." He turned and stormed down the hall. As a medical student, events like this were not uncommon, as there were always certain doctors who took perverse pleasure in making their subordinates feel useless and inferior.

Well, I earned my M.D. and thought that things would change. Now I was a real doctor and other physicians would respect me. Boy, was I wrong. Even with an M.D. after my name I was still a resident, a peon in the eyes of real attending physicians. This was never any more apparent than in the weekly M&M conferences. M&M’s had nothing to do with the tasty candies and everything to do with attending physicians verbally pummeling residents for any complications or deaths that occurred over the last month. Never mind that the patients were the ultimate responsibility of the attendings, or that many of the attendings approved the treatment decisions at the time. Many a time my colleagues entered M&M’s confident resident physicians and exited quivering lumps of self-doubt.

So what causes some doctors to think they are on par with God? Quite possibly the power to make life or death decisions for their patients gets to some doctors’ heads. Physicians are the ones that, with a pen, can write an order for a patient that saves his or her life. However, while we doctors may have the knowledge of what medication may save a life, do we have the ability to administer that medication? Doctors need secretaries to enter the order into the computer, pharmacists to prepare the proper dosage, and nurses to place the IV and administer the medication. Although we often forget it, we physicians do not exist in a health care bubble. We can’t do it alone. Many doctors still type with one finger at a time, have never used a mortar and pestle, and couldn’t successfully place an IV into a vein the size of a pencil. Yes, I’m talking about me.

I have a message to my fellow physicians. We need to lighten up. Laughter, they say, is the best medicine. I’d love to write a prescription for "Laughter" for the many doctors who take themselves too seriously. While the act of completing four years of college, four years of medical school, and surviving 3-8 years of brutal residency training is something to take pride in, it doesn’t give us carte blanche to treat others as inferior to us. As a plastic surgeon I am reminded every time I operate that I can’t do it alone. I need someone to gown me, plug in the cautery machine, arrange my surgical instruments and supplies, hold the retractors, and even work my iPod. I try to make an effort to thank the staff who support me each day, but admit that there are times I get frustrated and do not treat my support staff the way they should be treated.

The best compliment I ever received from a nurse had nothing to do with surgical skill or knowledge, but was when she said, "Dr. Youn, you’re one of the only doctors who is one of us". I hope I can continue to live up to that statement.

Signature: Anthony Youn, MD, FACS is a board-certified plastic surgeon and author of IN STITCHES, a humorous memoir about becoming a doctor. Dr. Youn's site is at www.institchesbook.com.

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Physician Income And The Curious Case Of Dr. Benjamin Brown

Physician income analyzed.

I stumbled upon a very interesting blog post the other day.  It's entitled, The Deceptive Income of Physicians, and was written by Dr. Benjamin Brown, a plastic surgery resident who is also the author of the upcoming book, Informed Consent: The US Medical Education System Explained.  Here's how it begins:

Physicians spend about 40,000 hours training and over $300,000 on their education, yet the amount of money they earn per hour is only a few dollars more than a high school teacher.  Physicians spend over a decade of potential earning, saving and investing time training and taking on more debt, debt that isn’t tax deductible.  When they finish training and finally have an income – they are taxed heavily and must repay their debt with what remains.   The cost of tuition, the length of training and the U.S. tax code places physicians into a deceptive financial situation.

The post is an interesting read and has generated a lot of discussion.  As of today, there have been 203 comments.

What I find most "curious" about this post-- aside from the passionate comments-- is the fact that I have never seen physician incomes analyzed like this before.  It is an unfortunate fact that most medical students remain completely naive to the financial implications of their choice of profession, and their potential specialty choices.

I wrote a recent blog post about this very issue where I quoted Dr. Robert Doroghazi, author of the book, The Physician's Guide to Investing: A Practical Guide to Building Wealth , as saying: 

"I believe the position of the academic medical establishment to deny medical students financial instruction is naive, hypocritical, and indefensible.  They should acknowledge that money is important.  It is never as important as your patient.  It is never as important as your family, your health, your freedom, or your integrity.  But is is important."

I couldn't agree more.

The medical establishment in this country should be ashamed of themselves.  Instead of having very frank and necessary discussions with medical students about the financial implications of becoming a physician, our medical leaders turn a blind eye to this very real need, and medical students are cast out into a harsh economic world with little financial knowledge to protect themselves and their families from potential financial ruin.

It is really an embarrassment to the medical community that this information isn't coming from the academic medical establishment, but a surgery resident who did the work in his spare time.

Thanks to Dr. Brown for making this information available to all of us.  I look forward to reading his upcoming  book.