Putting this into more modern language, as a profession, we not only put others’ well being ahead of our own, but we develop and maintain rigorous schools and science-based curricula. We set recurring accreditation standards for every aspect of our training. Even as accomplished professionals, we are regularly recertified. Expectations for achievement are high. We have built a profession around a calling with high ethics and high standards that is considered prestigious and is held in high esteem by our fellow citizens—even if at times we don’t feel that way.
Explore This IssueJuly 2018
We are a profession that has defined and pledged itself to a special societal role: to create and cultivate the appropriate conditions under which health and healing can best be promoted and accomplished.
So, if the most satisfying jobs largely are professions, does the fact that we don’t make the list of most satisfying jobs have anything to do with the health of our profession?
In 2011, Robert Tenery, MD, who writes a sometimes-tendentious blog on the challenges of organized medicine, said this in his entry entitled “What If There Were No AMA?”:
“Somewhere between the empty front porch swing and the illuminated CRT screens atop desks in semi-darkened rooms across this country, society’s priorities have shifted from community to self … Accustomed to those conveniences, but not wanting to individually participate, collectively, we are letting the responsibilities and social inequities that need almost constant adjustment, fall to others” (Published January 10, 2011.).
This, in my mind, speaks to some very important truths. With the vast expansion of medical knowledge, it is known to all of us and makes sense that medicine has become increasingly subspecialized. It follows that specialty and subspecialty organizations have grown. We need our specialty societies to be strong to represent the aspect of our work that is unique to each discipline. However, it surprises me how few physicians participate in organizations that represent the entirety of the profession. Less than 25%of practicing physicians are members of the American Medical Association (AMA), down from 75% in 1950. We need our large organizations like the AMA and the American College of Surgeons to focus on the broader issues that we have in common as healers and to represent the whole of our profession. They can represent us in what the healthcare system changes are doing to the role of physicians, the over-regulations that create nonhealing work for us, the growth of managers who are micromanaging our lives and are primarily concerned about output and not about patients first. So, how much has the fragmentation of medicine over time diminished our influence and our capacity to self-regulate as a whole? How much has abandoning our local and national professional societies that represent us collectively left us to fend for ourselves?