Dear Pre-Med Me

Dear Pre-Med Me


This letter written to her "younger self" as she prepared to go to medical school will resonate with many of Physician Outlook's readers. It is written by Dr. Diana Blum, a Direct Specialty Care Neurologist who is a well-spoken advocate and ally of Hippocratic Oath Medicine.

Dear Premed me,

Please take a deep breath before reading this letter from the year 2022.

The unfortunate reality is that practicing Hippocratic Oath Medicine has become near obsolete since you applied to medical school in 1999; in fact, defending the oath itself has become a tremendous challenge, and the resultant moral injury has caused a mass exodus of physician colleagues from clinical practice.  

You will wonder why you gave up your 20’s and early 30’s to study and train as hard as you did only to accrue hundreds of thousands of dollars of debt and to learn that much of the public has very little appreciation, much less value for, your rigorous education, training, or experience.  These days, an online degree with barely any clinical prep gets you the title “doctor” and a government-sanctioned license to kill.

The humble mentality you were once taught in medical school - “First do no harm because You don’t know what you still don’t know” is long gone. “Confidence” has replaced “Competence” because in today’s “Healthcare” purgatory, ALL “Providers” appear to be interchangeable.  Critical thinking skills are now a liability for employers, who prefer that patient care be delivered based on productivity optimization algorithms and that pesky oath physicians took just keeps getting in the way.

You will witness government sanctioned corporatization of your once sacred profession destroy the doctor-patient relationship by creating bureaucratic barrier after barrier. You will report examples of patient harm caused by the prioritization of profits over patient care only to realize those with power could care less about human suffering.

And just when you didn’t think things could get worse, you will discover that in the 2020s, scientific method principles and informed consent are no longer respected, instead, the “lived experience” mantra and “end justify the means” attitude make open and honest debate impossible.  Physician self-censoring has become the norm if you want to keep your paycheck and increasingly, your medical license.  

I don’t mean to be a downer, but the house of medicine is sadly divided at this critical moment in history, while ideological political agendas ensure that the crony status quo remains, and physician dissidents are silenced. 

On a more personal note, you will lose close friends to long battles with cancer, and empathy for their inhumane journeys through the medical industrial complex will motivate you to speak up and demand meaningful change. You will proudly join a grassroots movement that calls for #Transparency and #Accountability for the conflict of interests which have captured and destroyed our once trusted institutions. You will be fortunate to meet other inspiring Hippocratic Oath advocates, and many of these fellow Mama Bear Warriors will become some of your closest friends.

The learned helplessness you once felt being a cog in a broken system will be replaced by empowerment growing your own Direct Specialty Care practice.  The appreciation regularly expressed by your patients for the individualized care you provide will fill up your bucket with joy and strengthen your resolve to #takebackthehouseofmedicine. One day, you may even be invited to share your story and the wisdom you discovered while pursuing this calling.

May the following words of advice help you navigate the inevitable challenges you will face embarking on this arduous but extremely rewarding adventure.

  1. Have a daily self-compassion & gratitude practice.  This will make the darkest days feel a bit brighter
  2. Know your worth.
  3. Be kind.
  4. Don’t let your kindness and compassion be mistaken for weakness.
  5. Breathe. No really, pause and focus on your breathing at least a few times a day for 1 minute; your nervous system will thank you.
  6. Recognize that you may not cure many diseases, but you can comfort all patients.
  7. Default to assuming good faith intent but understand how conflict of interests drive decisions and behaviors; this is especially important when evaluating the “Business of Medicine”.
  8. Allow yourself to be vulnerable, understanding we are all a work in progress and that is a necessary step toward growth.
  9. Admit when you are wrong, admit when you don’t know something; you can’t build trust any other way and this is critical for healthy relationships, especially ones between doctor & patient.  And lastly....
  10. Learn how to genuinely forgive. Forgiveness is a helpful life lesson for physicians to teach and model for their patients. It eases much suffering, and this has a healing effect on the body. Imagine our society if more people were able to truly forgive.   

 

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