Our own Brian Rutledge (PGY-1) has recently been published in the Detroit Medical News:
I vividly remember my introduction to resident life. Coming off a six-month layoff from clinical duties, I was up early, lost in a new hospital, frantically trying not to be late. In medical school, a common analogy spoken for the speed and amount of learning necessary to succeed was that one must imagine they are “drinking water from a firehose.” Quickly on that first day, I would learn that residency would be much the same.
The breadth, depth, and speed of learning required of residents is undoubtedly a reason for decreased involvement of resident physicians within the AMA. During my time in medical school at Wayne State University, there was an active chapter of medical students that stayed involved in various events during the preclinical years. However, as I have learned during my intern year, resident involvement in the organization is not as robust. I was involved in the school’s AMA organization during those preclinical years of my medical school training, but as with many students, I was lost to follow up due to both the strenuous and irregular nature of my various clinical rotation duties. In addition to schedule difficulties, my fervent following of the discussion and passage of the Affordable Care Act left me disappointed with the political process and unsure how much difference one physician could make. By the time my residency began, I had no intent in pursuing any extracurricular political interest.
Unexpectedly, my opinion on this and politics in general would change with my training. As an intern, the relationships I have built with patients and their families has opened my eyes to the enormous financial difficulties that health care can place on those in need. A staunch proponent of unabashed free market principles as a medical student, I began to realize that these principles, while often promoting efficiency, must be measured due to their tendency to leave the vulnerable behind. I observed that this discussion was far from over with relation to the ACA. For the first time, I worked side by side with nurse practitioners and gained interest on the debate of scope of practice. Having only just begun my GME-funded training, I was distressed by the talk of cuts that could leave my future in the state at risk. Technological advances on a seemingly daily basis made evident that the way medicine is practiced now will undoubtedly be significantly changed in the future. With what I hope to be a long career ahead of me, I realized the impact of all of these concerns could be far-reaching.
Despite this, I was not yet ready for action until overhearing a discussion in my clinic between an attending and resident regarding the local Wayne County AMA Chapter. I chimed into it, noting that in fact I had once been involved in the AMA. At this time comfortable with the workflow of residency, I surprised myself when I told them I would join them at the next meeting. I surprised myself even more when I found myself actively enjoying participating in it.
I have learned at these meetings that resident and young physician involvement is often lacking within the AMA. In my own case, the strongest reason to rejoin the AMA was found by considering the lessons learned from an old favorite television show: “LOST.” In the show, survivors of a plane crash are stranded together on an island that has a variety of overt dangers and challenges. For many of the introductory episodes, the survivors are squabbling among themselves, at times violently. This continues until one episode a character named Jack pleads to the group that a rescue crew may never arrive and: “If we can’t learn to live together, we’ll surely die alone.”
The current state of American health care often appears to have the physician role in a precarious state. With so many current competing interests, whether it is government regulations or the pharmaceutical industry, hospital industry, or advance practice practitioners lobbying, that places pressure on the roles, responsibilities, and compensation of physicians, the outlook can at times appear bleak. In our recruitment of fellow physicians to organized medicine, perhaps one of the strongest messages we can continue to convey is what worked for this resident physician: “Live Together, or Die Alone.”
Dr. Rutledge has identified many of the issues that have increasingly troubled physicians. The last figure I have heard is a continuing shrinkage in membership with now only 11% of physicians as AMA members. If the organization showed success or even an understanding of how to approach the issues identified by Dr. Rutledge, this would be reflected in membership numbers increasing rather than continuing to fall. I believe physicians would rally around an organization that could define problems, organize itself around solutions and show some progress. Given the independence that has been characteristic of physicians and the diversity within the profession, change that is consequential, that does not just attempt to modify policy but actually creates policy of shared value to most physicians and their patients would be eagerly engaged. The question I would ask, is this possible? Can fresh, new, enthusiastic leadership that unfortunately must allow for diversity of political philosophies and the motivations of a diverse group of professionals emerge to serve us all?
Article originally published at http://www.wcmssm.org/