ational Doctors Day offers an opportunity to recognize the hard work that physicians across the country do every day. It’s also an opportunity to examine the challenges they face at this time of historic change in health care. Technological advances, the growing burden of chronic conditions, and uncertainty over the future of health system reform are reshaping medical practices and contributing to the job stresses that are associated with physician burnout and the looming shortage of physicians.
To better understand the profession from the perspective of those who are new or relatively new to it, my organization, the American Medical Association, recently surveyed a total of 1,200 medical students, residents, and physicians with 10 or fewer years on the job. The survey asked, among other things, why they became physicians, what challenges they face professionally, and whether they are satisfied with their career choice.
One answer that was loud and clear: medical students, residents, and young physicians overwhelmingly view the profession as a calling, one driven by an innate desire to help others. Nearly three-quarters of those surveyed said they heard this calling while still in their teens.
It happened for me in eighth grade. I grew up in West Virginia, where the African-American population was very small. I didn’t know any African-American female physicians in my community. In fact, I didn’t personally know any physicians. But as far back as I can remember, I wanted to be one. My inspiration came on Tuesday nights, when ABC aired “Marcus Welby, M.D.” Dr. Welby was a fictional character, to be sure, but he was invested in his patients and his community. He used his role as a physician to understand what was going on in a patient’s life beyond his or her immediate health needs and beyond the four walls of his office.
In my eighth grade science class, I discovered a budding passion for science. I also discovered a desire to effect change and, because of Dr. Welby, I knew medicine would give me the platform I desired to take care of people and to be a leader.
My parents instilled in me the confidence that I could accomplish anything if I set my mind to it. In college I was exposed to new, external barriers to my success — like being advised to choose a career other than medicine. My path wasn’t easy, but I was determined.
Later on, I remember being with one of my medical school classmates as we overheard a resident lamenting the challenges of being a doctor. His words were powerful, but they didn’t discourage us. My classmate and I made a pledge to stay positive despite the headaches, and always try to encourage a student or young physician. I have held strong to that promise.
Medical students face new and different challenges than I did. They must navigate a rapidly changing health care environment, where simply being an exceptional clinician isn’t enough to succeed, adding to the stress from student debt, too few residency positions, and the rigor of medical school itself. According to the survey, two-thirds of medical students today admit to having been discouraged from pursuing a career in medicine, with many citing the negative experiences of other physicians.
The AMA is working to address the numerous barriers medical students, residents, and physicians face. Over the past three years, our Accelerating Change in Medical Education initiative has provided grants to fund major innovations at 32 of the nation’s medical schools. This consortium then shares best practices with the goal of widely disseminating the innovative curricula being developed.
Challenges for the profession extend beyond education into the offices of practicing physicians, where we face a constant tide of change, from regulatory uncertainty and administrative burden to fluctuating drug prices and a growing population with chronic conditions. In spite of these pressures, 82 percent of the respondents to the AMA survey said they are motivated to continue their careers in medicine because of the desire to help people.
To help any physician find his or her way through the changing landscape of modern health care, especially as the nation’s health care system moves toward value-based care, the AMA recently launched a new health systems science textbook.
Physicians don’t have to face these changes alone. The AMA strives to provide timely, essential resources to empower physicians, residents, and medical students to succeed at every stage of their medical careers. The AMA mission — to promote the art and science of medicine and the betterment of public health — drives all that the organization does. To succeed at that, though, all physicians must play roles in making health care policy decisions and in shaping solutions. The perfect solution in 2017 won’t be the right one in 2027 — there will always be new technologies, evolving delivery systems, and changing health needs.
As the country today recognizes the work of physicians, we must commit to being leaders in our communities, in our society, and most certainly in our profession. Working together, we can continue to defend and improve our profession so we can care for our patients and improve their health and their lives.
Patrice A. Harris, MD, MA, is a psychiatrist and the board chair of the American Medical Association.