Nothing Special

Medical culture is full of falsehoods, things which are believed or assumed to be true which aren't, or at least aren't true all of the time. The further I get in, the more assumed truths I find out to be misleading or outright wrong, but there's one always seems to stick around, which I'm reminded of virtually every day.

This falsehood is that physicians are special.

It's the big lie of medicine. We promote it. Schools promote it. Hospitals promote it. Even patients promote it. And yet, it's not true.

Ok, sure, the average physician is usually pretty smart and has worked pretty hard to get to where they are. But that's about it.

With a few exceptions, physicians aren't geniuses. We aren't uniquely capable workhorses. We can't withstand sleepless nights any better than the average person, we can't memorize facts better than the next person, we don't have unique insight into the human condition, or an increased ability to handle stressful situations.

Doctors are just people. Regular, ordinary, slightly neurotic people.

When we forget that, we make very poor decisions. We overestimate our ability to diagnose and treat patients, often while ignoring contradictory information. We push ourselves and our bodies farther than they can handle, then deny that we've gone too far. We study for hours, believing it will all sink in, yet forget much of what we read because human memory simply doesn't work that way.

System-level decisions also draw on the myth of the super-human doctor, to disastrous effect. 24 hour shifts (down from 36 hour shifts). 80 hour work weeks (down from 100 hour work weeks). Drinking-from-a-firehose style learning. Chronic understaffing and/or overloading of patient volumes. Obviously there are other factors at play here - money being a big one - but I find a lot of systemic problems in medicine are supported by the notion that physicians can do more than an average human being and it's perpetuated because a lot of physicians believe it themselves.

At some point, the profession has to take a step back and admit there's nothing special about us - and that we shouldn't be given special (or worse) treatment as a result.