Finding the way back to the heart and soul of medicine

A message to all physicians from AMA President J. Edward Hill, MD.

By J. Edward Hill, MDis a family physician from Tupelo, Miss., was AMA board chair during 2002-03 and served as AMA president during 2005-06. Posted July 18, 2005.

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Years ago, my father taught me one the of the most important lessons of my life: Always have a compass in the wilderness. It's a lesson I've embraced both as a person and as a physician, and it's a lesson I plan to remember as president of the American Medical Association.

Let me explain.

When I was about 10 years old, my father took my older brother and me duck hunting. We spent the better part of a day wandering the Yazoo River swamps of Mississippi, my home state. But at some point in our adventure, we got ourselves turned around. By the time we realized what had happened, daylight was fading fast, and we weren't sure which way to head next.

Now, for those of you who don't know, the swamps of Mississippi can be a fascinating place to spend an afternoon. But they're a terrifying place to contemplate spending the night, particularly for a small boy.

There are spider webs as wide as the wall of a large room. Creatures that look like giant rats, called nutria, grow as big as tomcats. What's more, even though you know that alligators and snakes hibernate during winter, you can't help but think about them sleeping fitfully in their dens, especially when you're waist deep in water.

Oddly enough, though, I wasn't afraid that day. You see, as soon as we realized we had lost our way, my father pulled a compass out of his pocket, got his bearings and pointed us to safe, high ground.

I am not going to say that the going was easy. To get to higher ground, we had to persist and work hard. We also had to trust that we'd find our way before the eyes of the swamp rodents started glowing back at us in the dark.

My brother's primary concern was making sure the sandwiches I had in my knapsack didn't get wet. If it was up to him -- or me, for that matter -- we might still be lost. Fortunately, my father stayed focused on the critical factors: finding the right direction, staying on track and getting us to higher ground.

We finally made it out. I'll never forget that day, or the importance of having a compass in the wilderness.

This story reminds me a bit of how we sometimes feel as physicians: lost in the swamps.

All of us begin the adventure of medicine much the way my father, brother and I began ours -- with enthusiasm, high spirits and excitement. We can't wait to explore the world of medicine and patient care.

Yet one day, many of us find ourselves in an unfamiliar place, with night falling and no clear path to follow. Some of us focus on the immediate dangers, the spiders, rodents, alligators and snakes that all too often plague medicine, such as a number of personal injury attorneys, or the managed "cost" plans that focus more on profits than on patients or their care.

Still others of us do what my brother did, when he kept asking me about our lunch. In our frustration and fear, we think too much about the material aspects of medicine -- and not enough about our highest professional and social responsibilities.

Now I admit, we have to pay attention to the scary problems out there, just as my father, brother and I had to look out for spiders and rodents. It's also true that we want and need to eat, just like we need to pay our mortgages and staffs.

Yet we can't allow these challenges to prevent us from pulling out the compass that each and every one of us carries around in our hearts and minds.

This compass is not a physical tool but a professional, ethical, social, even spiritual one. This internal compass should have been instilled in us at the very start of our training. Some might even say it should be a requirement for medical school, along with high MCAT scores and good grades.

Why is this compass so important? Because it will guide us to where we need to go, as individual physicians and as a whole profession. This compass will always direct us home, back to the very soul of medicine: Healing the sick, comforting those beyond treatment, preventing harm, connecting to a higher cause, and most of all, caring for and about people and populations.

These values represent the very soul of our profession and our American Medical Association. These values are what I have pledged to uphold and protect as your AMA president.

In the coming year, I promise to take out my professional compass, use it and follow it every day, just as my predecessor, former AMA President John C. Nelson, MD, MPH, did before me.

I will use it when the AMA works to promote healthy lifestyles, including comprehensive school health education for our children.

I will use it as the AMA explores viable ways to address the shameful fact that 45 million Americans have no health insurance.

I will use it to help physicians enhance the safety and quality of medical care for all Americans, regardless of race and ethnicity.

And I will use it to address those issues that can cause physicians and patients so much anxiety and stress, such as pending cuts in Medicare payment or the growing medical liability crisis.

In short, whatever issues or controversies may arise in the coming year, I promise to use my professional compass to do the right thing for America's patients, as well as the men and women who care for them -- you.

Always, everywhere, no matter the cost.

Because that's what it means to be a physician, and that's what it takes to lead the American Medical Association.

J. Edward Hill, MD is a family physician from Tupelo, Miss., was AMA board chair during 2002-03 and served as AMA president during 2005-06.

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