I stumbled across a site on having a productive career that helps others. It has some interesting insights, but I'm particularly liking their analysis of the effects of being a physician. Physicians treat patients and presumably do a good job of it, but the overall effect physicians have on health is likely not that substantial for most patients. More importantly, physicians don't see that many patients in the grand scheme of things (though at times it certainly seems like they're seeing too many).
In medicine, a common, standardized way to evaluate how effective or how cost-effective an intervention is involved the use of Quality-Adjusted Life-Years (QALYs). I've always wanted to get an estimate of how many QALYs can be attributed to a typical physician, and the folks on this site have done a pretty good job, putting it at a maximum of around 2600 QALYs over a career. They further adjust for the marginal effect of any particular person choosing to become a physician - after all, there are diminishing returns for adding additional physicians, and if I wasn't in medical school, someone else would be. Presumably, I'm a better candidate than the person who would have replaced me, but I doubt the difference would be that substantial. They put the marginal effect of a typical person choosing to pursue medicine (and then doing so) at around 600 QALYs.
And even these numbers attribute the entire benefit of medicine to physicians, which is hardly the case. The estimates drop pretty quickly as you reduce the proportion of credit given to physicians. Anyway, it's worth checking out the analysis in full. There's a bit of room to quibble, but most of that pushes the estimates down - 2600 additional QALYs attributable to an average physician looks to be like a pretty reliable high-end estimate.
Now, saving 2600 years of life or providing the equivalent increase in quality of life is still pretty impressive, particularly in the developed world where the low-hanging fruit of improving people's lives (especially reducing poverty) has either been addressed already or is surprisingly difficult to make further strides against. Not all physicians have the same impact - higher quality physicians presumably have a greater impact and there are undoubtedly differences based on the specialty chosen and the nature of a physician's practice.
Yet, perhaps the greatest way physicians can help others is by donating to effective charities. Physicians earn a lot of money and do so rather reliably. A physician's charitable donations, if done efficiently, can provide benefits to humanity that dwarf what they provide in direct benefit to their patients, according to these authors' analyses.
There are additional avenues through which physicians can improve lives. Research and development can lead to broad improvements in quality of life across the world, well beyond what a physician can accomplish directly. However, not all research is successful in developing improvements for healthcare or overall health, and the real-world effects can often be modest. Advocacy is another avenue for improvement of overall well-being, but the average physician isn't that influential. There are ways to increase that influence though, such as formal or informal writing, or by working with advocacy groups for specific causes. Teaching can be another way to contribute, as knowledge translation is important to preserving current improvements in QALYs due to modern medicine and a strong teacher-physician may be able to improve the quality of the physicians they instruct.
So do doctors help people? Yes, but the direct impact isn't as high as many people think and there are other pathways that could have a much larger impact on humanity as a whole. Being a doctor is as much about feeling like you're doing good than it is actually doing good. That's not a criticism. It's important for us to enjoy our careers and feel valued at them - our quality of life matters too! Still, we should be aware of our own limitations and those of our profession. Physicians do good work. When I become one, I hope to do good work too, work that will hopefully help people. But the work we do isn't uniquely good and there are many ways we can have a meaningful impact on others' lives outside of our clinical practices.
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