Lets Learn How to Be Doctors Again

• Journal Listing
• BMJ
• 5.325(7366); 2002 Sep 28
• PMC1124230

BMJ. 2002 Sep 28; 325(7366): 711.

What's a good doctor and how do you brand i?

Doctors should exist good companions for people

Murray Enkin, consultant

Heart for Global eHealth Innovation, University Health Network, Toronto, Canada M5G 2C4

Editor—Imagine waking tomorrow to discover a magic lamp by your bed, and the genie tells you that there is but one wish left. Yous decide to devote information technology to making proficient doctors. What kind of people would these good doctors exist?

We enquire this question often among ourselves—a doctor embarking on his career, an active researcher approaching his meridian, and a retired clinician needing geriatric intendance. We sometimes ask other people also. Despite the disparate vantage points, the wish lists are amazingly similar. We all want doctors who will:

• Respect people, healthy or sick, regardless of who they are

• Back up patients and their loved ones when and where they are needed

• Promote wellness as well equally care for disease

• Comprehend the power of information and advice technologies to support people with the best bachelor data, while respecting their individual values and preferences

• Ever ask courteous questions, allow people talk, and listen to them carefully

• Give unbiased communication, let people participate actively in all decisions related to their health and health care, assess each situation carefully, and help whatever the situation

• Use show every bit a tool, not as a determinant of practice; humbly have death equally an of import part of life; and assist people make the best possible arrangements when death is shut

• Piece of work cooperatively with other members of the healthcare team

• Be proactive advocates for their patients, mentors for other health professionals, and ready to learn from others, regardless of their age, role, or status

Finally, we want doctors to have a balanced life and to care for themselves and their families equally well as for others. In sum, we want doctors to be happy and healthy, caring and competent, and good travel companions for people through the journey we call life.

Unfortunately, we practise not have a magic lamp, and at that place is no genie. We must utilize our ain skills and endeavours to brand the good doctors we desire and need. It is an awesome responsibleness.

2002 Sep 28; 325 (7366) : 711.

ABC of being a good doctor

Editor—I offer some quotations on being a skillful md.

"To exist a doctor, and so, ways much more to dispense pills or to patch up or repair torn mankind and shattered minds. To be a doctor is to exist an intermediary between man and GOD" (Felix Marti-Ibanez in To Be a Doctor).

"One of the essential qualities of the clinician is interest in humanity, for the hole-and-corner of the care of the patient is in caring for the patient" (Frances Due west Peabody in The Care of the Patient).

"Existence a good doctor means being incredibly compulsive. It has nothing to practice with flights of intuition or vivid diagnoses or even saving lives. It's dealing with a lot of people with chronic diseases that y'all really can't change or better. You lot can help patients. You tin make a difference in their lives, but you do that generally by drudgery—day later 24-hour interval, paying attention to details, seeing patient after patient and complaint afterward complaint, and being responsive on the telephone when you lot don't feel similar beingness responsive" (John Pekkanen in MD—Doctors Talk About Themselves).

"Yous can't know it all. And fifty-fifty if y'all knew everything that anyone else knows (which you can't, so end worrying about it), yous still wouldn't know what yous demand to know to aid many patients" (Perri Klass in A Not Entirely Benign Process).

Some of the qualities that a proficient doctor should possess are measurable, others are non. A good doctor should be:

A: attentive (to patient's needs), belittling (of self), authoritative, accommodating, adviser, approachable, assuring

B: balanced, believer, bold (yet soft), dauntless

C: caring, concerned, competent, compassionate, confident, creative, communicative, calm, comforter, conscientious, compliant, cooperative, cultivated

D: detective (a good doc is like a good detective), a good discussion partner, decisive, fragile (don't play "God")

E: ethical, empathy, constructive, efficient, enduring, energetic, enthusiastic

F: friendly, faithful to his or her patients, flexible

G: a "skillful person," gracious

H: a "human," honest, humorous, humanistic, apprehensive, hopeful

I: intellectual, investigative, impartial, informative

J: wise in judgment, jovial, only

M: knowledgeable, kind

L: learner, proficient listener, loyal

K: mature, modest

N: noble, nurturing

O: open minded, open up hearted, optimistic, objective, observant

P: professional, passionate, patient, positive, persuasive, philosopher

Q: qualified, questions cocky (thoughts, behavior, decisions, and deportment)

R: realistic, respectful (of autonomy), responsible, reliever (of pain and feet), reassuring

S: sensitive, selfless, scholarly, skilful, speaker, sympathetic

T: trustworthy, a great thinker (especially lateral thinking), teacher, thorough, thoughtful

U: understanding, unequivocal, up to date (with literature)

V: vigilant, veracious

Due west: warm, wise, watchful, willingness to listen, learn, and experiment

Y: yearning, yielding

Z: zestful.

2002 Sep 28; 325 (7366) : 711.

Skilful doctors abound

Editor—It is fairly like shooting fish in a barrel to define in a few words what makes a good lawyer, a good architect, or a adept writer, by maxim that information technology is i who wins difficult trials, who builds the best constructions, or who writes moving novels—no more qualities would be absolutely necessary. In contrast, to ascertain what makes a skillful doctor is a rather difficult chore.

A skillful md is not i who cures the most because in many specialties recovery is non a frequent outcome. Information technology is non one who makes the best diagnosis because in many cases of self express or incurable disorders the precise and timely diagnosis does not brand a nifty divergence for the patient. Information technology is not 1 who knows more scientific facts considering in medical scientific discipline ignorance is still rampant in several diseases. It is non 1 who is gentle, empathetic, and honest with the patient because these qualities are oft insufficient for an effective medical course of action. Information technology is non one who discovers a new fact or treatment because present new information is but a small fraction of knowledge to be inserted in the enormous puzzle of biomedical research.

Other professionals can be judged past their end results, merely a doctor can be defined equally good just when he or she has as many as possible of the above attributes. A good medico is simultaneously learned, honest, kind, humble, enthusiastic, optimistic, and efficient. He or she inspires total conviction in patients and daily renews the magical relationship that past itself constitutes practiced treatment for any kind of ailment and the best starting point for confronting all causes of pain and suffering. Although so many virtues are difficult to find in a single man existence, the medical profession is fertile ground for finding such combinations. Fortunately, in our profession skilful doctors grow.

2002 Sep 28; 325 (7366) : 711.

Some magic is required

Editor—As I recollect near the past when doctors were soothsayers, astrologers, historians, philosophers, artists, and so on, my feeling is that to be a physician requires a lot of scientific discipline but also a little bit of "magic."

Where does this magic come from? Well, it is a consequence of existence a complete, integrated person trying to assist other people past being understanding and caring but also knowledgeable, prepared, and ready to give your best—not to relieve lives but to brand them as good every bit possible.

But why do I consider it a gift, or compare it with magic? At that place is not a single slice of bear witness or the means to measure whether a doctor is good or bad. Patients need cognition, simply that is not all. They need someone who cares about people, non about illnesses.

As a recently qualified doctor, I consider myself ignorant in many means, but I know my limitations, and I hope to go better for the good of my future patients. A adept doctor should ever admit that he or she is human and has limits, but these boundaries must not stunt us. Secure in the knowledge that our boundaries make united states of america strong, we may excel, trying always to be better as human beings and doctors.

2002 Sep 28; 325 (7366) : 711.

We are trying to make doctors too adept

Editor—We are trying to brand doctors likewise good today, and that is the problem. Medical training demands that doctors chief at to the lowest degree the basics of a host of scientific disciplines—anatomy, pharmacology, molecular biology, information science, epidemiology, nutrition and diet, psychology, and so on. At the aforementioned time, they are asked to exist insurance specialists, anthropologists, ethicists, marriage counsellors, small business organisation owners, social workers, economists—the range of disciplines we inquire our medical students to consider is staggering.

The guilt is poured on equally articles announced almost every mean solar day in the literature, lamenting how piffling doctors know about some important issue or some other—doctors miss depression, don't ask virtually sexual behaviours, misunderstand familial corruption, don't know enough most subcultural beliefs, haven't been brought up to appointment on the functioning of the (fill in the blank) organisation, have not read up on drug interactions, ignore patients' spiritual needs, and on and on. Doctors reel under the latitude of expertise they are supposed to principal.

As order becomes increasingly medicalised, and more and more social bug that used to be the jurisdiction of law or religion (such equally drinking too much alcohol or coping with stress, street violence, or general world weariness) autumn under the rubric of medical care, doctors are expected to understand more and more than every bit they heal our social and our concrete failings. Doctors only cannot assimilate so much information, or at least they cannot assimilate information technology well. The truly good medico must, of form, be technically practiced and know the craft of medicine. In addition, however, the expert doctor must be able to empathize patients in plenty latitude to call on a community of skilled healers—nurses, social workers, insurance specialists, yoga teachers, psychotherapists, technicians, chaplains, whatever is necessary—to assistance restore the person to wellness (or perhaps, to support the person in their journey towards death).

To do that, the doctor must be able to be touched by the patient'due south life as well every bit his or her illness. The doctor need not be an anthropologist but must know how to ask nearly a person's culture; he or she demand not be a marriage counsellor but must be able to spot the signs of spousal corruption or the depression that may be the issue of a failing marriage. Skillful doctors are apprehensive doctors, willing to listen to their patients and gather together the full array of resources—medical, human, social, and spiritual—that will contribute to their patients' healing.

2002 Sep 28; 325 (7366) : 711.

Tools of the trade must be put to good utilise

Editor—Good doctors must exist able to put their tools to good use. With their ears, they must hear all that the patient tells. With their optics, they must run into all that the patient shows. With their easily, they must feel all that is hidden from their eyes. With their mind, they must detect all that is unspoken. When all this information has been alloyed, they must utilize their mouths to tell patients their thoughts and their torso linguistic communication to reassure. All the time, remembering their duty to the patients.

It must be remembered that equally a profession, we take the highest ideals and standards to uphold. We can do this only when we ourselves are well trained, accept the advisable time with the patient, and have patients who remember their duty to u.s.a. as well.

2002 Sep 28; 325 (7366) : 711.

Medical profession needs input from belief in humanity and ethics

Editor—In the developing earth with its deficient facilities and patients who need to eat before they need medical care, the medical profession needs input from a belief in humanity and the ideals of the task more than scientific professionalism.

A good medico needs to develop an affluence of patience; to explicate and educate before prescribing drugs; and to remember almost the proper decision—this does non always have to be what is written in the textbooks. Plush investigations that confirm only what history and examination have discovered have no identify, and neither have investigations that would not alter management.

The choice of treatment of a patient who cannot pay immense costs too needs special consideration, as does that of a patient who has to travel long distances to reach appropriate intendance. Taking time to explicate and understand, choosing the language to fit each and every patient, is not taught in medical school. Deciding to wait rather than to interfere, when interfering in a scarce and too short lived way would only prolong suffering, sharing the sufferings from illness not just in a biological but in a social sense these are skills that a good doctor definitely needs but is not ever successful in developing.

Recognising your limits and acting only within them and giving yourself the chance to gain relief and regain energy are sometimes more important than just hanging around helplessly in a busy ward. Honesty and humility—the slogan of my medical schoolhouse in Khartoum—are easy to write and say but very difficult to do in an overpressed emergency section where tiredness and nervousness gain the upper hand.

2002 Sep 28; 325 (7366) : 711.

Being a patient helps

Editor—Bated from the obvious benefits of a fine medical schoolhouse, great teachers, and lots of easily on clinical feel, I think the very all-time way to produce a good (sympathetic and humane) medico is to force educatee doctors or residents to become patients.

I believe every medico in pupa should have many tubes of blood drawn over a few days past poor phlebotomists, have a nasogastric tube inserted once or twice, undergo a thorough sigmoidoscopy, barium enema, and bowel preparation, and possibly even be made to spend a nighttime or ii confined to a hospital bed, plugged into an intravenous drip, and then exist subjected to harried and uncaring staff doctors and nurses while crippled.

I'll bet a case of wine that this trenchant exercise will produce far more empathetic, sympathetic, and proficient doctors then multiple lectures on sensitivity and humanism past some medical bookish, ethics professor, or member of the cloth. I daresay that I truly believe that my experiences of beingness a patient as a student sure as hell helped mould me into the caring and sensitive practitioner I am today!

2002 Sep 28; 325 (7366) : 711.

A nurse speaks

Editor—From a nurse'south indicate of view, beingness a practiced doctor is non that hard. Good doctors have graduated from medical school so should have a reasonable depth of knowledge to inform their decisions.

The primal to condign a skilful doc is to gain the confidence not to demand support when capable of carrying out a job or making a decision and to ask for help and back up when not capable. Retrieve, the clinical picture is more important in most circumstances than the laboratory results. Look at the patient, not the numbers.

A skilful doc also needs to be a squad thespian. Nurses and those in professions allied to medicine tin can brand your life easier or harder. Well-nigh firm officers and senior house officers have express practical knowledge of the specialties, whereas nurses often take many years of feel—apply this to your advantage. You volition non lose your authority past asking for their help just volition gain nurses' respect for realising your limits. Nurses frequently know consultants quite well and tin can tell you lot what information they like bachelor on their ward rounds and when they would favour existence asked for help and advice.

Call up, nigh nurses don't envy your responsibilities only practise wish to have their concerns heard and answered. We don't heed our advice being overturned. Nosotros just want to know you have registered our concerns, have thought about them, and weighed the pros and cons of action or inaction.

Finally, and often hardest to achieve, is good communication with patients. Listen to them, and try to be compassionate. The ultimate responsibility for health decisions is theirs. Remember this. Policies and procedures can be bent to suit the patient, but remember to document that it was the patient's request.

It looks so uncomplicated written downwards similar this, but most doctors still find these attributes hard to larn.

2002 Sep 28; 325 (7366) : 711.

A patient speaks

Editor—For several years I was registered with a wonderful general practitioner in my home town. I never appreciated him until I moved away to study at academy.

I went from being an empowered individual to a patient number. There was no recognition that I had existed before I joined my new practice—the staff never referred to whatsoever of my previous dr.'southward notes. Information technology was upsetting to sit beyond the desk from the full general practitioner, give an business relationship of what had happened, and so find out that the salient points had not been recorded in my notes. My suggestions for what might be happening were treated with, I felt, derision. After all, what would I know—I'm a mere patient.

It got to the point where I would see my general practitioner only if I had a off-white idea of what was going on. If I were concerned or worried I'd return home and run into my "real" general practitioner as a temporary resident. And so why was ane general practitioner wonderful and the other not?

My real general practitioner became my proficient best friend. He took an interest in me equally a person and non equally a set up of symptoms. He knew when to speak and, more chiefly, when to shut up. My history was my history, not his questions with his answers. I felt empowered and never bullied into taking a course of action that I didn't want to follow. He seemed to realise that I might be improve placed to make suggestions about what was going on. My experiences lead me to make the following every bit a summary of a good consultation.

The doctor asks questions; patients give answers. The doctor uses his or her knowledge and skills to help patients brand sense of their answers; patients ultimately determine what they want to practice with their doctor'due south support. My unhappiness arose when the doctor filled in her own answers.

2002 Sep 28; 325 (7366) : 711.

Eulogy for a skilful dr.

Editor—In June this year I went to the memorial service for an exceptionally good doctor, Phyllis Mortimer. I had been both a colleague and a patient of hers some years ago. An inimitable woman (one of three women in her year of 150 medical students), she had graduated despite having polio every bit an undergraduate and myriad health issues that continued all her life.

Perhaps this explained something of the pity she had for her patients and her sheer humanity. Jungians speak of the concept of the wounded healer: that clinicians must exist aware of their own woundedness so patients can detect the health in themselves. The relationship between the two of them becomes in itself a creative medium unique to that run into. The protocol is a necessary, just enormously limited, tool, which provides merely the beginnings of good intendance. Real testify based practise is fluid, ever changing and continually revisable specific knowledge. Some of the necessary cognition is that which is created in the consulting room itself.

My husband and I had treatment for subfertility for about five years with several clinicians. Phyllis cared for me through many months of information technology. With her, dissimilar others, the unpleasant procedure was no more invasive than if she were looking in my ear. This was due to her gentle concrete handling of me (despite her own handicap with hand and arm) but specially because of her interpersonal skills, which were nil short of extraordinary. She was besides the only clinician nosotros encountered who was able to work (and work well) with the continual disappointment of treatment failure. As her colleague (at the fourth dimension I was the regional lead for quality improvement), I knew of Phyllis'south reputation for searching to extend the technical quality of care and likewise of her gifts as writer, dramatist, and director. Phyllis also had her flaws. But it was her capacity for equality and sensitivity of relationship—and at the same time holding her professional boundaries and standards—that made her such an uncommonly good doctor.

She relished the chance to notice artistic means of communicating simply likewise with the patient from a severely deprived background every bit with the educated patient. Phyllis's consultations were of a dramatically higher standard than most I have witnessed over the years and uniquely tailored to the patient in front end of her.

At that place is no such thing as the perfect doc. The good doctor is non i type or one affair. He or she is "good enough" in the Winnicottian sense—someone who is truly mindful of her or his own limitations and the profession's limitations. The skilful doctor has a loftier tolerance for "non knowing"—an ability to suspend judgment and work with situations of high intractability. He or she is e'er searching for, moving towards, and finding creative solutions in the moment at mitt, able to concord both hope and failure simultaneously, beingness different things to different patients and thereby meeting myriad needs.

Can you imagine a world where more than clinicians, similar Phyllis, were able to transform their inherent handicaps into increased effectiveness? That would mean powerful medicine indeed.

2002 Sep 28; 325 (7366) : 711.

At present I am retired . . .

Editor—What is a good doc? How do we make one? Now I am retired I know how to be a proficient doctor. I know how to listen to a patient. I know how to put myself at the patient's disposal. Put down your pen. Turn away from your desk. Face the patient. Sit dorsum. Give him or her your total attention. Just thus will yous fully sympathise the trouble.

Earlier I took up medicine I knew what fabricated a good doc. I was a mature pupil. Furthermore, I had had all-encompassing feel of being a patient. I had often had blood taken through an old fashioned, reusable needle, had had barium meals, sigmoidoscopies, nasogastric feeding, intravenous drips, and more than than one functioning under general anaesthesia. I knew what a good doctor and a skillful nurse were like.

Once I was qualified things were rather dissimilar. Although I was yet total of youthful idealism, I became less inclined to sit and listen. I seldom had the chance to sit at all. All the same, I loved the work, and, on the whole, I loved the patients. I nonetheless felt compassion and swain feeling for them. But as time went by, things changed. For one matter I was perpetually enlightened of fourth dimension's winged chariot hurrying virtually and most of the time it seemed to exist accompanied by the hound of sky.

Although I had studied art, literature, and philosophy, although I had the souvenir of tongues and of clear thinking, if not of clairvoyance, I institute that the benison of charity, of the milk of human kindness, was leaking out of my soul, squeezed out by the pressures of work, of financial feet, of a wife and five children to care for and keep happy, of nights broken by the cries of my own children or the urgent clinical needs of others, of committee work and administrative responsibilities. I became less patient with my patients, less tolerant of the foibles of the man race, less willing to listen, less able to care.

Once I retired, withal, things changed once more. Suddenly my financial worries were over. I had savings instead of debts. Most of my children had left the nest. I had time once more than. Doing locum consultant piece of work here and in that location when I felt inclined had all the pleasures and little of the pain of full time consultant piece of work. No committee meetings, near no administrative duties. Merely ward rounds, outpatient clinics, teaching, and on-telephone call duties every three or four nights. The outpatient clinics were more often than not less heavily booked than I had been used to. I could sit back and listen to patients and their parents, could put myself entirely at their disposal. It made a tremendous difference.

If I had my time again, would I practise it whatever differently? I'm non sure. I hope I would worry less. I hope I would exist more patient, with the patients and with myself. Simply nowadays it would be all different. Whereas in my first preregistration chore I was on call for 108 hours a week, nowadays I might at worst be on for eighty hours. In all my xxx years from qualification to retirement, except when I was in the U.s.a., I was ever on a one in two rota. Nowadays as a consultant, I would be on a 1 in 4 rota at worst. Would that brand it easier to love one'south patients? I sincerely hope so.

2002 Sep 28; 325 (7366) : 711.

Teach medical students reality to make good doctors

Editor—To make a practiced doctor nosotros need medical schools to exist honest with students and teach them near how things actually are. We need to provide medical students with that almost powerful and dangerous of life forces—reality.

Some patients tin be difficult and unsafe. Most clinical decisions take no prove base. Pursuing ethical aspects of each case is an action that needs prohibitively intense resource. Dubiousness looms over all of medicine, and you must exist able to cope with the pain and guilt that it brings.

Nosotros teach students about a cosy, idealised medical environment that really exists in the minds of the academics. When students feel the real globe they practice not see the majority of doctors spending a vast amount of time discussing ideals with patients. They detect the evidence base to be sorely deficient. They soon realise that many serious illnesses can present with minimal signs and symptoms, and they must somehow devise a personal style of coping with the pain and guilt that this uncertainty produces.

I believe that we impairment our medical students by not being honest virtually the real medical environment in which they volition eventually practise. Nosotros need to give them the skills to assistance them make their patients healthy but we as well need to give them the skills to help them remain salubrious themselves. Placing students in a real medical environment with scarce skills simply confuses and alienates them and ends upwardly damaging everyone. If we want to make good doctors then we must teach them in the existent world.

2002 Sep 28; 325 (7366) : 711.

How non to do it

Editor—First of all, have "raw" medical graduates and place them in a busy medical unit. Write a task description that details their remainder periods merely not their function, their tasks but not their contribution. Make them piece of work with an ever changing diverseness of senior colleagues—not for them an erstwhile fashioned apprenticeship. Ensure that they never see the aforementioned patient twice considering compliance with hours is more important than the insights they proceeds from providing continuity of intendance.

As they motion into specialist training, crave them to collect and collate precise details of everything except the quality of doctoring they are learning to provide. Teach them that they too can profit from the drug industry through its necessary supplementation of written report leave budgets. Brand sure that resource in your institution go where they are actually needed—the only figurer doctors need is betwixt their ears.

When the time comes for research, apply this opportunity to reinforce the importance of numerous competing regulatory frameworks in providing the bureaucratic framework essential to employment in NHS management and its support industries, and to deforestation.

Equally with all healthcare providers, ensure that their salary, once trained, is sufficiently small to attract merely those who are (or should be) committed.

When problems of professional exercise arise, information technology is better to go someone who isn't involved in providing health care to accept it on—they aren't constrained by their understanding of the system they take been asked to modify, and the system will cope with all the rogue recommendations—we always take.

The fundamental principle underlying this approach is attending to detail. If we collect all data available, write detailed task plans, and provide coherent written justifications for everything, then all will be well. Practiced doctoring is zip more than than the sum of these individual parts, and those who contend that there is some college value system, some "professionalism" which should be involved, belong in the past. Count everything and value nothing.

Non.

2002 Sep 28; 325 (7366) : 711.

Summary of responses

Editor—Altogether 102 people wrote in response to our questions "what makes a good doctor?" and "how tin can we brand ane?"^14-ane They were clearer on the kickoff question than the 2nd, list more than 70 qualities a good md should have. Amidst the usual—compassion, understanding, empathy, honesty, competence, commitment, humanity—were the less anticipated: courage, creativity, a sense of justice, respect, optimism, grace.

Responses came in from 24 countries all over the world, and almost all of the respondents had something different to say, indicating, equally 1 respondent put information technology, that "a skillful dr. will exist unlike things to different people at different times." For some, the notion was very uncomplicated: a dr. who satisfies his or her patients; a doctor you would trust yourself; a doctor who likes people and likes the job; fifty-fifty "a doc who feels for himself the sorrow of homo kind."

For others, it was more difficult. Like describing a good motorcar, a good play, or good weather information technology all depends on your perspective. A fellow member of the library faculty at a New York academy described a proficient doctor equally one who "reads and reads and reads." A professor of bioethics (with an interest in medical history) argued that good doctors are also proficient historians, calculation that medical history should take up at least a quarter of the undergraduate curriculum. Educators gave a high priority to being a expert instructor, jitney, and mentor. And a quality comeback specialist thought a good doctor was one who critically examined what he or she did and tried to amend on information technology.

Patients, however, wanted footling more than than a doctor who listened to them.

From this corking multifariousness a few common themes emerged.

Firstly, there are plenty of practiced doctors around and we should nurture them better.

Secondly, to exist a proficient dr., you outset have to be a good homo: "a skilful spouse, a good colleague, a good customer at the supermarket, a good driver on the road."

Thirdly, information technology's easier to be a good doctor if you like people and genuinely want to help them. A general practitioner from Wolverhampton wrote: "To like other people, from this all else follows. Liking your patients will get you through the grind and tedium of your working twenty-four hours, and patient contact will exist a source of forcefulness and renewal. You may fifty-fifty do some good."

Finally, good doctors, dissimilar good engineers, practiced accountants, or good firemen, are non just better than boilerplate at their chore. They are special in another way too. Extra dedicated, extra humane, or extra selfless. More traditional contributors wanted doctors to sacrifice themselves for the good of their patients. Others said doctors must expect afterward themselves first—or they wouldn't be able to aid anyone. Doctors are patients as well.

Few respondents had annihilation to say about what makes a adept doctor in specialties with little patient contact. Pathology, for example, or epidemiology. At that place wasn't much either on what makes a skillful surgeon. One of only eight contributing surgeons (a urologist from Saudi Arabia) wrote that skilful surgeons are "good doctors with extras." Another surgeon said that it was important for doctors to notice medicine fun, fascinating, and stimulating.

Making a good doctor seemed a greater challenge than defining one. In that location was full general agreement, though, that we aren't very proficient at it. To paraphrase 13 responses: all we can promise to do is select students with the right gifts (not the right test results) and somehow stop them from going rotten through overload cynicism and fail during their preparation and early career.

One starting time year intern from Israel echoed several others when she suggested bad societies were unlikely to produce practiced doctors: "Whilst doctors are overworked, underpaid, and abused, the debate on defining a good doctor will remain academic," she wrote. "Our social club undervalues doctors still expects and volition accept nada short of perfection . . . Fifty-fifty with perfect risk management mistakes will be 'made' . . . people will die young or decline with age, and not all pregnancies will have a adept upshot. Unfortunately doctors are more easily sued than God, and moreover . . . pay cash."

References

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Articles from The BMJ are provided here courtesy of BMJ Publishing Group

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1124230/

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