Greater Louisville Medical Society
President's eVoice
May 2014
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May 2014
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This child is curious; always getting into things, not in a bad way, but in a joyful way. This child can grasp complexities with relative ease, can understand the roundness of the world, gravity, and that anything divided by zero is infinity. At some point this child's gaze turns earthward enough to learn the system. Grades, awards, and accolades come in quanta. Pride arrives. There will be more schooling. A student emerges.

This student learns, expresses, yearns, and dreams. And at some point along the didactic journey this student catches a glimpse of a destination. There is no turning back. Medical school happens. An explorer emerges.

Running toward the edge, then leaping, this explorer feels the rush of new air, the exhilaration of wonder, and the anticipation of plunging into the water rapidly rising from below. This baptism requires boundaries and deference to practicality. Residency training is completed. A physician emerges.

Emerges to an environment ruled by the forces of conformity.

From the moment this physician enters the wormhole of a medical education, the system seeks to constrain, program, harness, package, and automate this free thinker - all in the name of value-based quality. There's no blame. It's what the system is designed to do.

However, a creative mind wilts under the weight of endless regulations. A compassionate soul suffocates in the digital coils of impersonal informatics. A joyful heart fatigues fighting the payer's resistance to a thoughtful plan of care. And this physician is tagged, branded, and blended into the health care provider herd. A demoralized physician emerges.

The demoralization of our physicians has consequences. In 2007 a survey found that 57 percent of physicians would not recommend that their children pursue a career in medicine. Five years later, that number had grown to a staggering 90 percent. Moreover, at least half of physicians surveyed said, given a second chance, they would not choose medicine again. Factors include: exhaustive electronic data requirements; lack of practice autonomy; devalued physician input for developing system protocols; increasing demands to see more patients in less time with fewer resources; rising tides of unclear regulations; diminishing influence, fairness and respect among payers; and most disturbing, the physician's perception that one's ability to provide high quality care is on an unalterable downward spiral.

We don't start out feeling this way. In August 1981, on my first day of medical school, one professor welcomed us with the surprising declaration that a portion of our class would graduate but never practice medicine. "Regardless," he said from the podium, "you will have been afforded a medical school education, perhaps the greatest learning experience our society can offer, unveiling the mystery of human life as few will ever understand it. That will be your gift. What you do with it will be your responsibility."

Anyone who has been faithful to this responsibility knows the road is not easy - important things rarely are - and that the road provides ample shares of both elation and devastation. When one's mission is to alleviate suffering, suffering can leave its mark. Then change occurs.

But to what extent do we change?

A recent discovery provided me with a clue. While going through some old boxes I came across a copy of my medical school application. Seeing those yellowed pages, rekindled a memory of that late night in the summer of 1980, sitting alone in my parents' basement, filling out the forms, typing away on my vintage Royal manual typewriter. As I read the "personal comments section," composed by my twenty-year-old-self nearly 34 years ago, I grinned and wondered how I'd ever gotten accepted. Included among the six highly emotive paragraphs was this passage bursting with confidence, na´vetÚ and honesty:

Something is calling me. People, they need me. Medicine, it needs me. Not so much because of the condition of medicine in particular, but more so because every profession does indeed need me - or else people like me.

And people like you.

There is a shortage in our profession - a shortage of practical dreamers who can remain child, student, explorer, and physician.

Your profession and your patients need you to be this physician.

And you need you to be this person.

Emerge again.
Let's Connect -
James Patrick Murphy signature
James Patrick Murphy, MD, MMM
GLMS President 

GLMS Mission

  • Promote the science, art and profession of medicine
  • Protect the integrity of the patient-physician relationship
  • Advocate for the health and well-being of the community
  • Unite physicians regardless of practice setting to achieve these ends.