Currently, internal medicine is suffering from an existential crisis. We have forgotten who we are. On my way home from Pittsburgh yesterday, I finally had an inspiration. I understand what has bothered me so greatly.
To paraphrase Covey, workers often find themselves hacking their way through the jungle, managers close behind sharpening machetes and writing policies. Then the leader climbs the tallest tree, surveys the entire situation and yells, “Wrong jungle!”
As I learned and teach medicine, the focus of everything we do is the patient. We have too many organizations and advisors trying to fix internal medicine. They seem to focus on management issues. I tire of conversations about system based practice. I rail against tranforming guidelines into rules or financial incentives.
Being a physician is about leadership more than management. Too many well intentioned influence agents want to restructure internal medicine. They talk about the patient centered medical home or comprehensive internists. I fear they detract attention from the key point. Physicians have total responsibility to our patients not systems. We must figure out in what jungle our patients find themselves. That is our responsibility. That is our calling. That is what I love about medicine.
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1 Response to We should be leaders not managers
Jared
December 12th, 2007 at 6:33 am
First principles question about this rant. What is broken about internal medicine?
-j