Gift of healing requires knowledge, empathy, integrity

A message to all physicians from AMA President Peter W. Carmel, MD.

By Peter W. Carmel, MDis a pediatric neurosurgeon in Newark, N.J., and is immediate past president of the AMA. Posted July 4, 2011.

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During this time of historic change for America's health care system, it behooves us to remember that practicing medicine is a gift, and with that gift comes a special responsibility. I talked about this during my inaugural address at the AMA Annual Meeting. I also believe it is a good subject for my first column in American Medical News because sometimes we may get so caught up in the day-to-day concerns of practicing that we lose sight of what our work -- and our calling -- is really about.

As physicians, our first responsibility is obvious -- to help our patients, each man, woman or child who walks through our door.

Of course just because it's obvious, that doesn't mean it's easy. For me personally, my first week of biochemistry quickly wiped out any notion that medicine would be easy.

Our responsibility to the patient boils down to three words: knowledge, empathy and integrity.

Perhaps in no other field is the pursuit of knowledge more important than in medicine. New therapies, new procedures and new technologies are discovered every day. As physicians we must always push ourselves to master them. In medicine, knowledge can mean the difference between life and death.

But what good is knowledge to the patient who has just been told he or she has inoperable cancer? For that patient, knowledge is not enough.

There must also be empathy. As doctors, we must balance knowledge with compassion. We must remember that patients come to us when they are feeling most vulnerable.

For a physician, sharing that vulnerability is a privilege and a sacred obligation. But our responsibility to the patient does not end there.

In his "Physician's Prayer," the 12th-century philosopher Maimonides wrote, "Inspire me with love for my art and for Thy creatures. Do not allow thirst for profit nor ambition for renown interfere with my profession ..." Maimonides stated it well. His words are a reminder that as physicians we must never let our judgment be clouded by a sense of entitlement. That is, we must never trade our objectivity for a steak dinner or a spa weekend. We must never let the desire for personal autonomy stand in the way of patient interests. We call that integrity.

Physicians value autonomy. But today, even the best physicians must be ready and willing to collaborate, to work in teams and pool our knowledge on behalf of our patients.

As I said before, our first responsibility is to our patients. But as physicians, we have a second responsibility as well, and that is to the community.

Across the richest nation in the world, our American communities face an epidemic of chronic disease.

Today two-thirds of adults and nearly one-third of children are overweight or obese. Since 1980, the number of Americans with diabetes has tripled. Almost 14 million Americans have a history of heart attack or angina. And every 40 seconds, someone in the United States has a stroke.

As physicians, stemming the tide of chronic conditions that threatens this nation must be one of our top priorities. So next time that office door opens, be sure to engage your patients on their lifestyle behaviors. Take advantage of that opportunity!

One individual, one at a time, we can all make a difference. The AMA gives you the tools to do it -- even within the eight minutes allotted by contemporary scheduling demands.

For example, the AMA is currently collaborating with the AMA Foundation on a national family obesity prevention campaign. It not only will build public awareness but also will give physicians the tools your patients need to help manage their weight -- from patient self-assessment forms to action plans, progress calendars and even some online tools.

The program, called "Healthy Life Steps," launches this summer and will initially involve pilot projects in three cities -- Albuquerque, N.M., Memphis, Tenn., and Newark, N.J.

In addition to using these resources in your daily work as physicians, remember that campaigns like these lend themselves to coordination with larger community efforts.

In Newark, where I work at the New Jersey Medical School, we're sending physicians and medical students into the school system to counsel children on healthier lifestyles and to do body mass index measurements. We call the program "Physicians Against Childhood Obesity in Newark." We will work closely with Newark's mayor, Cory Booker, as well as first lady Michelle Obama's "Let's Move" efforts in the area.

Wherever you live, and whatever your cause, get involved in community outreach. Push for an end to health care disparities. Push for increased access to care. Push for disease awareness, education and prevention. As physicians, it is our obligation to be pushy.

Beyond our patients and our communities, we have a third responsibility, and that is to our great and noble profession.

More than a year after the Patient Protection and Affordable Care Act became law, there is still much unrest in the House of Medicine.

Across the country, many physicians feel under assault, burdened by administrative and technology requirements, confused by new delivery models, terrified at the prospect of increasing patient loads without sufficient support from the government.

Every day, round the clock, new rules and regulations on health care are being developed on Capitol Hill. And every day, round the clock, the AMA is responding to them.

When the Centers for Medicare & Medicaid Services released complicated criteria to qualify for electronic medical record incentives, the AMA created simple fact sheets to walk you through the process.

When the government attempted to slash Medicare reimbursement, the AMA launched a full-scale ad campaign to stave them off.

When insurers engage in unfair practices, the AMA goes to court and fights -- and wins -- on behalf of you and your patients.

Quality. Practice management. Scope of practice. Patient safety.

Whatever the issue, whatever the state -- the AMA is the trusted adviser that America's physicians need.

I am proud to be president of the AMA this year. I look forward to working for you, and with you, during my time in office. Because ours is a unique profession, and we have a sacred trust to fulfill its obligations.

Peter W. Carmel, MD is a pediatric neurosurgeon in Newark, N.J., and is immediate past president of the AMA.

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