So the last time we met in class, there was a little discussion about some of the strange things doctors will say about public health. For example one of my females classmates mentioned that she encountered a medical director who said that he did not care about public health and that he had no qualms about prescribing broad-spectrum antibiotics to his patients--anything to save a life.
Of course what he said was rather shocking to a class of public health students especially since it was coming from a well-educated (we hope!) medical professional, but the real issue is how did he get to possess such a view? I believe that somewhere between medical school and where he is now, he decided to place his patient as his top priority, and every decision and action he undertook from then on served to support that belief he held. The view he holds now wasn't something that was created overnight, it started as a shaky belief substantiated by his actions and decisions over the years.
What I learned from the doctor is this: for those of us about to embark on new careers, we have to realize what it is exactly that we stand for--what are our beliefs and what do we really want to fight for. Because over the next few years, we will engage in actions and decisions that will strengthen that stand and our beliefs will become part of who we are. And even if that stand appears ridiculous from another perspective, it is something that we have fought so hard for that we are unwilling to let it go no matter how silly it seems.
Figure out what you want to believe in, and start it out right--you may never get a chance to change it again.
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8 comments:
Does the needs of the many outweight the needs of one? Your right, this is a struggle that doctors and public health officials approach in different ways. It must be difficult to actually have to make that decision everyday and I can see why doctors decide both ways. Its a debate that will never end.
I like your demands that we determine and commit to our beliefs, such that when we face real world problems, we aren’t confused as how to proceed. The idea of ethics is profound, and can apply to all areas of our busy professional and personal lives, so I’m glad to hear somebody bring it up. The ability to see a bigger picture (systems thinking perhaps?) could help alleviate some of the narrow-minded attitude of this physician. However, from an ethical perspective, we might agree with this doctor that he is doing what is right for his patient. So regardless or our ethical soundness, our paradigm or worldview might affect what seems ‘right’ to us from different perspectives. In other words, I think that even if we commit to certain beliefs now, we have to beware of not allowing ourselves the flexibility to adapt to circumstances over time. The challenging situations we face in our lives present potential conflicts of interest, and we have to be able to see the big picture in an ever-changing environment in order to make the best decisions.
Wilson,
Well said. My father used to always tell me "If you don't stand for something, you will fall for anything." I believe that's true for our careers in public health too. It can be very tempting to just go with the prevailing thought rather than stand up for what you believe in.
Rosie
Hey Wilson. I like your description of a "female classmate" :)
I agree with you. Two things come to mind:
1. Do you think we'll be able to reach a point where we can do what's best for our patient and for society as a whole? Is there a way to do this?
2. I've noticed that Dr. Shahi has a belief that information to the public cannot be bad. That if there is a way to inform the public, we should do it. and he sticks to that belief in various situations, be it bird flu, SARS, HIV/AIDS, etc. It seems to be a belief that he has reached through years of experience and contemplation.
I think I myself have certain beliefs that I hope I won't go against in the future, but I also want to build upon these. I feel like this class is helping us do this by exposing us to what is going on, even if we are not "out there".
when I was study at medical school I knew I was going to continue my carrear as a public health professional and it ws difficult even to talk about it with my profesors. And when I start the MPH program there where a lot of our clasmates that could not understand how come public health it is a spciality for a doctor, It seam to me that what is hard for people is to understand that at the end what doctors and public health professional are doing is part of the same porpouse.
Nice Blog Wilson,...Several articles I have come across have mentioned that the way to improve public health and the global warming issue is to establish a curricula in medical schools as well as in public health schools that will explore medicine from a population viewpoint. Even without the issue of public health, such a curricula would be a good starting point for refuting such tunnel vision. Today’s global world and all its health ramifications, call for a bridge between the medical profession and public health, and the curricula could lay the foundation for such a bridge.
Hi Wilson,
Your point about the pretentious doctor standing firm on his beliefs is a common attitude among old school medical professionals. He has every right to believe that his number one responsibility is to cure his patients. Whether he prescribes antibiotics and his patients become cured simply from the placebo effect - he is within his moral parameters by suggesting that his job is to help people get well. As public health professionals we cannot be angered or surpised by his attitude because it's a lot more common than most of us would like to admit.
Newer medical professions have a much broader understanding of the purpose of public health, as Marina mentioned. Many of them have first hand experience with schools of public health and many even have dual graduate degrees.
The field of public health is still fairly new compared to the rest of the professions in this nation (let alone globally). We have to, as Jack said, uphold moral responsibilites within this field so that old school medical physicians see that we are all on the same path to help the community "live well," and as Liyan said encourage continuing education to bridge the gap between public health people and medical professionals.
Hi Wilson,
I would also like to point out that it is a growing trends for MD students to also get their MPH (I've heard its preferred for those who want to work for Doctors Without Borders). So while we were all shocked to hear such comments, I think many of the future MDs will hold greater respect for the MPH curriculum.
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