A Physician as hero has a long history. As anesthesiology, Dr. Karen Sibert, M.D., observed in “Remember When Doctors Were Heroes?” for the website, Op-Med, “For a long time, physicians were exempt from America’s anti-intellectual disdain because people respected their knowledge and superhuman work ethic. The public wanted doctors to be heroes and miracle workers. The years of education and impossibly long hours were part of the legend, and justified physician prestige and financial rewards. Popular TV series in the ‘60s and ‘70s lionized the dedication of Ben Casey, Marcus Welby, Dr. Kildare, and Hawkeye Pierce. In real life, heart surgeons Michael DeBakey, who performed the first coronary bypass operation in 1964, and Christiaan Barnard, who performed the first heart transplant in 1967, became famous worldwide.”
Times have changed, however. If police officers faced off with a crazed killer to protect you and your loved ones, you’d call them heroes. And you’d be right. If firefighters carried you to safety from a burning house, you’d marvel at their selflessness, as anyone would. Much less often does the hero label get applied to today’s Physician, even though they’re regularly crucial to your longevity and quality of life, from the cardiac surgeon who massages your heart in his or her hands, to the pediatrician who treats your child’s scary asthma episode. We say “thank you for your service” to firefighters, police officers and the military, but not to Physicians. Why? There are many factors that explain this. We pay Physicians directly for services rendered, and for years, the myth has been established that all Doctors are rich, dividing their time between the golf course and country club. The others are “public servants” with taxpayer funded salaries. Add to this the fact that more and more women have become Physicians (and experience the same gender-based pay gap as other professional women) – a fact that Dr. Sibert theorizes could arguably contribute to an unfair erosion of public respect. She asks, “Could it be that the anti-intellectual tradition in America tolerates highly educated men in the doctor’s role, but can’t quite stomach giving the same respect and pay to highly educated women?” Now that’s a depressing thought.
Whatever the reason, Physicians suffer from a general lack of trust and respect that is detrimental to the administering of health care. In this issue of Physician Outlook we shine a spotlight on the selfless actions and lives of the Physician in this complicated and fragmented world that is sorely in need of heroes.
The Selfless Physician
First, an understanding of why Physicians have heroic and selfless tendencies. Medicine is not just a career, it’s a calling. It’s an avocation, as well as a vocation. The expression “busman’s holiday” comes from the concept that a bus driver on vacation takes his family on a road trip. Physicians’ holidays take the form of volunteering in underserved neighborhoods and answering urgent calls from their Patients regardless of the time and circumstance. Take the case of Dr. Amanda Hess, an OBGYN M.D. and member of the Physician Moms Group from Frankfort, Kentucky. She had checked into the hospital and was ready to give birth to her own second child when she heard nurses rushing to the aid of one of her own Patients who was in labor, intense labor. The woman had to give birth right away because the baby was in distress with the umbilical cord wrapped around the neck. Although a Doctor was on the way, Dr. Hess knew the woman couldn’t wait. So, she delivered the woman’s baby and had her own baby a few hours later. This dedicated Doctor didn’t hesitate when duty called at a time when most people would be fixated on their own life.
It’s not unusual for Doctors to go beyond the call of duty, and adhering to their medical oath. It’s not only selfless dedication that prompts so many Doctors to volunteer their services after spending many hours running their own practices or working long hours at clinics or hospitals. Volunteering is actually therapeutic for Doctors. In an article on MDLinx entitled “Physician volunteerism: The surprising benefits for doctors who do it” author Liz Meszaros explains that current research including some done at the Institute for Social Research, The University of Michigan, Ann Arbor, shows that for “physicians, who often bear the brunt of administrative responsibilities, patient illnesses, and tight daily schedules, a little soul boosting can go a long way. In fact, many physicians claim that volunteering can be refreshing and actually help reignite their passion for medical practice.”
She says that volunteering helps with controlling stress, anger, anxiety and depression. It’s a mood and confidence booster, and provides a renewed sense of purpose and professional pride. Louis Weinstein, M.D., a retired obstetrician/gynecologist, isn’t spending his golden years on the golf course. He volunteers at the Barrier Islands Free Medical Clinic in Charleston, South Carolina.
Meszaros reports that Weinstein is loving the volunteer experience. He explained, “I can spend time with my patients. Anything I do for them is because I genuinely want to do it. If a patient needs a biopsy, I schedule it for 40 minutes, or I take an additional 10 minutes talking to them about smoking cessation rates. If spending extra time talking to my patients can prevent one stroke, one heart attack or break the cycle of poverty for one person, then I’ve done more than enough. It was more than worth it to me.”
The Courageous Physician
What distinguishes Physicians from the average citizen is the same dynamic that separates firefighters who naturally run toward fire from those who instinctively run away from the flames. Physicians see people in physical or mental distress and run toward them without regard to whether they are “on the clock” or not. Another great example of this is the case of Natalie Stavas. In the article, “Heroic Doctors Who Went Beyond the Call of Duty,” featured on MIMS (Monthly Index of Medical Specialities) and again in the Los Angeles Times, Boston Globe and on the Huffington Post, Dr. Stavas (a pediatrician at the Boston Medical Centre) was profiled. She had been a runner (along with her father) at the annual Boston Marathon in 2013. Just blocks away, she heard explosions and ran towards them, but the police were barricading the path. Somehow, she got through the barricades, running on a broken foot, shouting to the police that she was a Doctor and could help. At the time, she told the Boston Globe, “I’ve never seen anything like that before — like a true, utter battle zone.” According to reports in the Los Angeles Times, she performed CPR on one woman, then, “She kept moving on to other victims. She plugged the gaping groin wound of a woman in her 30s with a borrowed T-shirt. She used other bits of clothing to stanch the bleeding from one man’s mangled foot, and another’s broken calf bone.” The police were concerned about clearing the area fearing another bomb would go off. That’s when they forced Dr. Stavas to leave the scene. The reason she was in the marathon in the first place speaks of Dr. Stavas’ humanity. According to the LA Times, “When she broke her left foot training weeks ago, she let her doctor know she still intended to complete the marathon. She was running for charity, and couldn’t let her father down.” Later that year, she was honored by The Boston Globe who named her the “2013 Bostonian of the Year.”
Most recently, Ebola survivor Rick Sacra, M.D., assistant professor of Family Medicine & Community Health at the University of Massachusetts Medical School, was honored earlier this year with the Gerson L’Chaim Prize for Outstanding Medical Missionary Service by African Mission Healthcare for dedicating his life to Christian missionary work in West Africa with SIM, an international Christian mission organization. Dr. Sacra’s amazing story while he was delivering babies in Liberia during a terrifying Ebola epidemic in West Africa. Dr. Sacra contracted the disease but remarkably was able to survive it. Most people would have thanked their lucky stars and moved on with their lives, not Dr. Sacra. He opted to go back to Liberia as soon as he was able. He said he had Patients to take care of there, and wanted to be part of Liberia’s efforts to rebuild their communities. The award came with a $500,000 prize, which Sacra and the ELWA hospital is using to train Liberian family Medicine residents, install solar capacity and establish intensive care units with trained staff.
Helping Physicians Through Legislation
Physicians are willing and sometimes eager to serve the underserved both in this country and around the world. The families of Physicians are the unsung heroes, also. They give up quality time with their loved ones while they work long hours to bring quality health care to their Patients. But Physicians need help.
Bipartisan legislation has been introduced in the Senate called Rural Physician Workforce Production Act, which is cosponsored by Senators Jon Tester (D-Mont.); Cory Gardner (R-Colo.); and Cindy Hyde-Smith (R-Miss.), and the Training the Next Generation of Primary Care Doctors Act, which is cosponsored by Senators Jon Tester (D-Mont.); Susan Collins (R-Maine); Shelly Moore Capito (R-W.Va.); Doug Jones (D-Ala.); John Boozman (R-Ark.); Joe Manchin (D-W.Va.); and Kamala Harris (D-Calif.). This legislation will help increase access by allowing residents in all medical specialties to gain practice in rural areas. Many urban and rural hospitals have partnered to effectively promote rural training by establishing rural training track programs. However, current law restricts the ability of hospitals to expand these programs. The Rural Physician Workforce Production Act addresses this issue by eliminating caps on urban and rural hospitals that have prevented them from expanding or creating new rural training track programs.
“The doctor shortage in rural America threatens the future of frontier communities in Montana,” Tester said. “If we want more doctors to practice in rural areas, we need to train them in rural areas—and these bills will help build a stronger pipeline of medical residents from universities to our rural hospitals.”
The Rural Physician Workforce Production Act lifts the current caps on Medicare reimbursement payments to rural hospitals that cover the cost of taking on residents. This change will eliminate the serious disadvantage that rural hospitals face when recruiting residents. The bill also allows Medicare to reimburse urban hospitals that send residents to train at rural health care facilities during a resident rotation, and it establishes a per resident payment initiative to ensure rural hospitals have the resources to bring on additional residents.
The Training the Next Generation of Primary Care Doctors Act reauthorizes the Teaching Health Centers Graduate Medical Education Program and provides $647.5 million over five years to support residency programs in rural areas. The bill will also provide an additional $60 million to help existing Teacher Health Centers to expand primary care, dental, and psychiatric services, and meet the growing need for care. These bills seek to do good for Physicians who want to do good.
