I don't post much anymore. In fact, my engagement with the medical community, especially online, has plummeted over the past year. That's been partially by circumstance, but in many ways by design. For my own sanity, speaking less to and about doctors - and consequently more about things other than medicine and to more non-physicians - has been extremely beneficial.
Much of the reason this has been beneficial stems from a deep and unfortunately persistant disappointment I've had in this profession. While most physicians are well-intentioned, generous, and competent individuals, many are not, and these individuals are rarely if ever held to account. It takes extremes of incompetence or selfishness for a physician to suffer consequences for their actions and, even then, the consequences are frequently below any reasonable standard that would compel changes in actions from anyone but the offending party (and even then only because of monitoring requirements). Because of this impunity, less-than-stellar physicians feel comfortable justifying their positions to learners - including residents like me - who have no real power to contradict them, and even trying to push these learners to be more like them.
On a broader scale, the good intentions of the majority of physicians don't always translate into good actions, particularly on issues outside of the area of expertise for most physicians. In recent years, physicians and physician groups have put an emphasis on political action. Yet, because most doctors have a poor understanding of economics, law, or politics, it's led to what I've seen as a number of well-meaning but poorly thought out positions being embraced by wide swaths of the profession (implementation of user fees is the most common example of well-meaning but poorly thought-out policy physicians seem quick to endorse). That these positions happen to benefit physicians or reinforce prevailing stereotypes in medicine is unsurprising, but reinforces my disappointment in the profession.
Doctors are human and therefor subject to the same biases that afflict the thinking of all groups, but due to our positions of privilege and power, the failure to confront these collective biases more easily leads to harm than it might for other groups without such influence. Despite claims to the contrary, physicians retain significant authority, particularly with regards to the healthcare system. Even when physician political preferences don't become implemented, the driving forces behind these positions remain. As individual physicians hold a significant amount of minimally checked local power over their own practices, departments, hospitals, or institutions, misguided political positions can lead to ground-level actions on the part of physicians which replicate - in part or in whole - the harms threatened by the unimplemented political beliefs of physician groups.
To be blunt, I got tired of dealing with physicians at work who weren't coming close to living up to my standards of what a physician should be, then coming home to spend what little free time I had hearing from even more of these physicians who reinforced that disappointment.
Taking time away from physicians allowed me to step back a bit and gain some perspective. It has let me acknowledge that progress has been made in this profession, even if we still have quite a ways to go. It has allowed me to notice where physicians are doing things right, and that there are many individuals who are largely living up to the promises of the profession. It has helped me realize that some of my standards were unrealistic or too narrowly defined, such that in my mind, reasonable doctors got thrown into the same bucket of bad actors without real justification.
Most importantly, it's helped me learn that disappointment shouldn't lead to despair or withdrawal. Doing so only allows the disappointing actions to propagate. Obsessing - which I was doing before - is no better, but a middle ground is possible. I've started looking for more productive ways to engage with the medical community, ones which allow me to channel any frustrations into positive actions. I can't say I've come close to fully figuring out how to do this to my satisfaction, but I feel much closer than where I was before.
Learning to tune out negative, unchangeable viewpoint and focusing on how to change my own actions (rather than trying to influence others to change theirs) have been worthwhile first steps. These were easy enough to do independently and primarily benefited me. The next steps - extending impact more broadly - are harder to do at all and even harder to do well, because they involve other people, but it's been heartening to explore options available to me. I'm still very early in my career, which leaves many paths open and means I can take the time to choose the ones that best fit my goals, my values, and my strengths. Taking a step back has led to some tentative hope, that while the medical profession falls far short of the standards it should be easily meeting, it is moving towards those goals - even if it doesn't always seem that way when immersed in the middle of the loudest voices of the profession.
