Editor's Note
Role Play
Some days you could barely see the other side of the room for the smoke. Encased by the haze were mostly green-clad men sitting on the couch, drinking coffee from their personalized mugs, dragging on their cigarettes, trading “war stories,” and occasionally getting up to grab a sweet roll. Saturday morning at the local greasy-spoon? No, this was the physician’s lounge at one of the hospitals I frequented in the late 1970s. Although the Surgeon General’s report was ancient history by then and the medical literature was clear about the health detriments of smoking, here was a public display of bad health behavior from a group of physicians trained to promote health. What kind of an example was that? Or should doctors be examples? If we pen the right prescriptions, cut in the right place, and mouth the right recommendations, does it matter who we are or what we do? Actually, it does.
Physicians think most about being judged by their professional performance. Patient satisfaction surveys, pay-for-performance ratings, and even Minneapolis St. Paul Magazine’s Top Doctors poll provide some measure of how a doctor does as a doctor. Yet patients, other doctors, and society often look at who we are as people as well. Whether we like it or not, we physicians often find ourselves in the role of role model.
For centuries, medicine has relied on role models to pass the torch to the next generation of physicians, from apothecary apprentices in early America to residents and interns today. It is an acknowledgement that book learning only scratches the surface and can’t provide the tutelage in honesty, compassion, and completeness that close contact with a mentor can. Rarely do physicians look back and say, “I really admired that textbook.” But they do say all the time that they really admired a person who molded their professional life. Certainly, physicians who teach think about this and try to move past discussions of fluids and electrolytes to conversations about what it means to have a calling.
Whether called or not, we all play roles besides doctor. We also walk through each day as parents, spouses, church parishioners, voters, and community members. Just as our actions as mentors can change a student’s life, our organizing and advocacy outside of medicine can alter society. Role model seems like a pretentious title in this context, but society does notice what we do outside the clinic.
Our personal behavior also is noticed. Good health habits carry weight with patients. Doctors who smoke have a harder time convincing their patients to quit. (I once knew a two-pack-a-day internist who thought he had done his job if he convinced a patient to switch to Salems.) Obese patients may not take weight-loss advice from an obese doctor as seriously as they would from a physician who has conquered his own weight problem. People in 2009 don’t want their doctor to work 100 hours a week, overeat, underexercise, and then crash and burn by the time they’re 50. We physicians need to walk the walk.
Today, the doctors’ lounge at my hospital serves nutritious lunches (although sweet rolls are still in evidence), and the hospital has just installed an exercise room for medical staff use. Doctors now have fewer excuses for not polishing up their act.