Doctors take pulse of hard times

Patients are not the only ones frustrated with their experiences at the doctor’s office. A Nov. 15 and 16 “Doctoring in Hard Times” conference, which was sponsored by the Center for Bioethics and the Acadia Institute, highlighted the rising discontent of physicians too. The event marked the second Renée C. Fox Symposium, which was established in 1999 in honor of the Penn medical sociologist.

Opening the conference, Carla M. Messikomer, president of the Acadia Institute, said she realized that the medical climate had changed when her own family physician of several years abandoned private practice. More so than ever, said Messikomer, physicians are looking for other options, some of which include early retirement, non-clinical careers in the pharmaceutical industry and part-time clinical practice. Messikomer said that despite these serious changes in the profession no real discussion has been devoted to the issue.

So who’s to blame for the current crisis in clinical practice? Ned Cassem, chief of psychiatry at Massachusetts General Hospital and symposium keynote speaker, pinned it on HMOs. He said they cared more about the bottom line than about quality patient care.

But not every conference attendee agreed with the Harvard professor. A resident at the Hospital of the University of Pennsylvania said that improvements in the profession can start with medical training. He said medical education should teach physicians how to be effective public health care advocates.

The socialization of physicians was another issue the symposium touched upon. During a panel discussion in which Annenberg Professor Emerita of the Social Sciences Renée C. Fox served as moderator, the point was raised that doctors’ struggles are related to their inability to respond to stressful clinical environments. “If you’re in a battlefield situation, you are steeled to death,” said one physician. Fox picked up on this idea of the “non-biomedical aspects of [clinical] education.” She said that how physicians respond to social and cultural stimuli may contribute to their current frustrations.

Originally published on December 5, 2002