During my entire career I have seen unwarranted and unseemly squabbling between town and gown. Yesterday's rant discussing the feasibility of academic medicine as a career brought out the town side of the squabble. I often hear the gown side insult the town side.
While I went straight into academic medicine, I did moonlight in community hospitals. For the past 6 years I have taught part time in a community hospital and part time in an academic VA hospital. I find yesterday's negative comments about academic medicine unfortunate just like I find insulting practicing physicians unfortunate.
Both practicing physicians and academic physicians practice on a spectrum. We have great academic physicians who never worked in private practice. The great physicians do understand the world of practice and avoid insulting private MDs.
In community hospitals we have many wonderful physicians and some who are less good. I find the former more common than the latter.
So why are we so quick to criticize the other? I believe these criticisms have the same origin as any prejudice. As humans we identify with our tribe and usually have an opposing tribe to criticize. These critiques make us feel better about ourselves and our decisions.
But these critiques have (I believe) little foundation. The comments on the academic question showed bias and a lack of understanding of present academic medicine. Unfortunately, I believe, they showed anger at those who prepared the writers for practice.
Town and gown has likely always existed. I hope that I teach students to respect both. I hope I do respect both. I encourage everyone to understand that town and gown are not that different and both necessary.
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Well said, DB. It’s so easy to criticize another when we don’t have all the information about what they go through. And remember, we only see the other Doc’s failures and unhappy patients. The ones with great results remain where they are. Personally, I tired of the squabbling among professionals. Today I employ my new skills on Internet marketing to gain more freedom, less stress, peace of mind, and pretty much the same income as when I practiced. I see more and more Docs doing the same. Some retired, others just tired. For information, visit: http://drsmithdeal.com
I’m not sure how town and gown are different. Everyone who works in a town graduated with a gown. They both are required to meet state CME requirements. Both are required to sit for their boards to be considered board certified.
So I’m not sure how one can differentiate the skills of one from the other. In fact, I worked with some of the worst doctors in 15 years during my residency. Academic physicians who had no business taking care of patients.
They belonged only in a lab but were forced to see patients to keep their job.
The big difference between working in an academic institution and not is less call, having someone else do all the busy patient work for you and more teaching.
None of these factors make one better than the other for patient care.
I jumped on Wikipedia and read the article, but it was a lot like walking through pudding: slow going and afterward I felt kinda dirty.
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