To what expectations are physicians held? Of course, there is the Hippocratic Oath, but does that suffice? I was at my parents’ home in California recently, and we were sitting in the living room having a lively discussion. Or in other words, my mom and my wife, Nasreen, were discussing habits of mine that they seem to have observed over due time, and grown to mutually despise. I admit, I have a poor habit of changing out of my work clothes and leaving them right where I changed (with the intention of hanging them when I’ve found the proper motivation). After ranting about this habit with Nasreen, my mom then turns to me and says “Yassar! Who is going to want a doctor that doesn’t pick up their clothes? I’m serious! You’re a doctor, you can’t be messy like that anymore!” Besides the fact that I’m not a doctor yet, I guess I failed to realize my medical license hinges on hanging my H&M shirts right away. Kidding, though I did think this exchange was quite fascinating because it revealed an underlying notion that we know to be true, and that is people hold physicians to a different ethical/moral standard than other professionals (this may well apply to healthcare providers in general). In fact, it’s probable that we physicians and future-physicians hold each other to this ‘higher’ standard, as well.
There is a broad spectrum for disagreeable behaviors that a doctor is chastised for engaging in. For example, if a lawyer were seen smoking a cigarette outside of a courthouse, hardly anyone would develop a preconceived notion about his/her competency in matters of law, let alone the quality of a person they are. Though, can you imagine the outcry that would occur if this ad were to run in Time magazine today?
If an immoral or despicable act occurs and is then circulated through news media, the element of shock would be much stronger if the suspected perpetrator is a physician. The extreme end of the inappropriate behavior spectrum deals with…well, extremists. Physicians that are particularly bent on destroying innocent lives based on ideological furvor. A prototypical example is Dr. Benjamin Goldstein, an American physician who singlehandedly killed 29 people and wounded 150 others in the Cave of the Patriarchs massacre in 1994. Medicine and Terrorism clearly do not mix.
During my white coat ceremony, I distinctly remember Dean Richardson speaking about the purported involvement of two doctors in the failed London car bomb plot of 2007. Dr. Richardson expressed appropriate disgust at the idea that doctors would be involved in the potential destruction of innocent human life. He accurately stated that physicians must stay true to the essence of their profession or run the risk of losing public trust, an invaluable asset. Dr. Richardson made an extremely relevant point. For the sake of our profession, our colleagues, and the general public, physicians must strive to conduct themselves in an upright manner. We are not only carrying the reputation of our individual careers and livelihood, but also that of our medical colleagues (to be transparent, one of the accused has been cleared of all charges and is practicing medicine again, while the other has been sentenced to 32 years-to-life).
There is a reason that we especially cringe when we hear of other physicians engaging in practices of gross negligence, such as one-time Portland surgeon Jayant Patel, dubbed “Dr. Death”. This is because each known case of inappropriate care results in both defiance of the principles of medicine, and further public disillusionment with the medical field. It is because of these expectations, whether justified or not, that I feel every physician, medical student, and aspiring medical student must have a firm moral compass by which he or she uses to influence decision making. Whether or not this morality is given by religious doctrine or is of personal makeup holds little relevance to this context…just as long as the compass does not run contrary to the principles of doctoring. While I know I have shown extreme examples of doctors engaging in crude ways, lesser crimes lead to negative consequences too, albeit on a smaller scale. So I guess on that note it’s about time I pick up my clothes.