Do the Opinions of a Non-practicing Physician have Merit?

The worth of an opinion is the worth of the man or woman delivering it.

Given the competitive streak that’s deep in the bone of every physician, it is inevitable that many doctors on the verge of moving away from the clinical arena will wonder if they’ll have an audience any more.

If we’ve spent 20, 30 or 40 years with people eager to hear your point of view, it would take a Zen master ego to calmly walk away, unfettered by thoughts that you might be viewed as over the hill, out of touch or redundant. If you proffer an opinion you may, in turn, worry about the reaction of colleagues still yielding their stethoscope.

Realistically, your only concern will be with any negatives they might express – such as:
1. Some blend of not practicing/out of touch/chip on shoulder.
2. Not practicing thus free to pontificate.
3. No longer a member of the team; don’t care what he/she thinks.

It is human nature to find an ‘out’ at times when we may want to ignore or downplay an opinion that is displeasing to us. We physicians are good at this.
If I’m not seeing patients, then my opinion may lack merit.
If I’m a physician with a lot of administrative responsibility as I was as a department head, then my opinion may be devalued because “he’s not practicing enough”.
If I practice in a non-surgical discipline, then I might be told “well, you wouldn’t get it because you’re not a surgeon”.
The academic may be criticized by the private practitioner because he doesn’t see the same number of patients and has the buffer of house staff.
And so on.

In the final analysis, after all the chaff of human pettiness is discarded, the worth of an opinion is the worth of the man or woman delivering it.

Are they experienced and thoughtful?
Are they honest about their background and potential biases?
Are they conscientious and consistent?
Are they truthful rather than being ‘political’, or the representative of some institution or organization which may inhibit their speaking freely?


The physician is the high priest of medicine to their patient

In preparing myself for a surgical procedure, I’ve had a reminder of how rituals soothe and prepare us for significant events in our lives, facilitating our passage through otherwise anxious moments. It’s been one more example of the advantage that accrues to a doctor who is sometimes a patient.

Like anyone undergoing an entirely elective procedure, I’m aware that I’m taking a spin on a roulette wheel where I may have almost every number covered, yet one or two remain exposed. However controlled the risk, you can’t eliminate it all together. Confidence in my surgeon still allows for some anxiety on my part. In the past week, I’ve presented myself twice at the hospital, first for a preop evaluation by an internist complete with EKG and varied blood tests, and then to the preop visit with the surgical team.

At one level the visits themselves might seem minor matters. After all thousands of such encounters take place daily in a large medical center. To the clerks, PA’s and physicians I met, I was almost certainly just one more person to check off the daily clinic list. The young internist kept telling me I’d be fine for my knee surgery though it’s my hip that’s coming out. The PA in orthopedics was not aware that I’m a physician, although my degree is listed after my last name on the record, and so instructed me accordingly.

While I wasn’t the recipient of greater understanding or reassurance about my physical capacities, the mental reassurance was significant. Days away from d-day, I’m aware of greater calm relative to a couple of weeks ago. These advance troops have gently eased me through a funnel into some narrow channel where I will travel for a time. I feel comforted, not constrained. The odds of my getting cold feet and balking at the last minute are diminished, the channel is cocoon-like, allowing a transformed me emerge at the other end.

Growing up in a staunchly Catholic family, my exposure to the rituals of the Roman church was broad and long. Agnostic for as long as I can remember, I can still feel the pull of vestments, chant and incense. If all senses were reached, those of vision and hearing were particularly so.

After a while, you could see with your eyes shut, hear through your bones. Eyes closed, you were transported for a time to a different world. Even now, working at my desk, if I listen to music, it is most likely to be plain chant. It soothes and reassures.

The physician is the high priest of medicine to their patients, yet I wonder how many of us think of this as we perform our daily duties. Our patients know they are much more than a wobbly joint or a malfunctioning kidney. Understanding the power of ritual makes a good physician great.