I so enjoyed the worship, praise and prayer time at the Canadian Medical and Dental Society Annual Meeting in Edmonton this year. It's hard being 'good' as a doctor. Often there's more reward in doing the opposite of what healing is. Too often you find that doing good gets you in more trouble than doing nothing. Neglect and avoidance, cherry picking and various other strategies are financially superior to actually doing a good job. Even what is 'good' is called 'subjective' with monetary considerations masquerading under other names. Euthanasia is all the rage but really do I want my doctor as I'm growing older to be rewarded for my departure anyway possible. When I first worked in hospitals the hospital stays were based on medicine and pathology but now it really has become a factory shute with doctors rewarded financially in places for early discharge. So what happens when there's a euthanasia option and the patients insurance coverage isn't all it's said to be.
I sat with other doctors who do good in a world where good and bad aren't defined in any moral sense but increasingly in terms of profit and loss.. I weary of the strain of trying to have patients get off drugs, stop drinking, change their lifestyle and follow through with medical advice. So many of my patients won't even get blood work or X-rays and I'm left choosing to do nothing or give antibiotics speculatively, assured that they will get them only if I insist on daily dispensing along with the methadone the patient might go to the pharmacy to get. And everyone insists that I am my brother's keeper but no one is there with me when he is at his worst. No one but another doctor or another helper perhaps.
We learned this week of the Christians who stayed to help in the plagues while the smart doctors of the day ran. It's little different today.
I'm wanting to engage in conversation about quitting smoking "everything" and the patient's agenda is to get medical marijuana. There's a matter of cross purposes.
Each doctor I talked to described some similar decision making situation in their area of speciality. A cardiologist described how choosing not to get an unnecessary angiogram with potential risk for the patient meant he made less money and explaining his decision to do right took more time and cost him more whereas simply doing the angiogram would have been much more lucrative.
So what to do to maintain one's hope and pleasure in the practice of medicine. Why not give up and go into administration, take a cushy government job, become an activist or another health care critic in a world of more and more critics and fewer and fewer doers. Everyone wants to avoid seeing patients especially those without resources and especially those with little hope and bad attitudes.
I feel alone and unsupported in doing the ethical and morally true things in my profession. I've a lifetime of practice highlighted by hard moral decisions and ethically right decisions that put me in conflict with powerful and sometimes corrupt institutions with wholly different agendas than saving an individual patients life. I hear things like "you have to crack a few eggs to make an omelette' and wonder why I didn't accept that this applies to the person I'm seeing. More and more I'm told the person is just a 'customer'.
It's comforting to sing uplifting songs with a group of fellow physicians. It's heartening to sit quietly in prayer asking for God's guidance in your work and relationships.
And it's downright fun to hear someone say, "I read a book once and it says we win".
Praise the Lord! We live in the Father's World. What a beautiful song that was to sing the last day of a deeply moving reassuring conference of kind and caring Christian physicians. Thank you, all those organizers and their families for making this very special time possible.
I thanked one organizer and he shared that he didn't take praise well but had learned from his grandmother who always accepted thanks by saying,, "All glory is the Lord's" .
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