A layperson’s list of New Year's resolutions for physicians

Back by popular demand, here’s a layperson’s list of New Year’s resolutions for physicians.Social media training. In a world of extreme transparency, it’s easy for patients to peer into the personal lives of physicians through social media. What they’ve seen over the past few years may be causing more harm than good. Here’s why: First, social media makes it easier for people to think, rightly or wrongly, that some physicians have a “do as we say, not as we do” mentality. If they hear doctors urging caution during the respiratory illness “season” but see them doing something else, it breeds cynicism and undermines credibility. Second, some social media behaviour can create a detachment between physicians and the public when it lays bare the disparity in socio-economic means between the two groups—especially when most folks are struggling with the cost of living. Third, social media is an echo chamber riddled with confirmation bias. Physician opinions on some health matters are as heterogeneous as the medical profession itself. When all those opinions are expressed on social media, it allows the public to opinion shop and simply pick the one they like.Read: Matt Maruca: A layperson’s list of New Year's resolutions for physiciansImprove pediatrics. There is a growing attraction by the public to anything labeled “wellness,” including for children. There is also an annual frustration amongst parents of the long wait times in children’s emergency rooms. Together, it suggests a vacuum not currently being filled by the medical profession, but also an opportunity to be proactive. There is no greater proactive upstream initiative than pediatrics. If physicians move in a robust way toward fostering healthy lifestyles and habits through education of children and parents, in clinics and schools, it fills the void that misinformation is currently filling and creates significant downstream benefits for society. Pediatricians would also be wise to reconsider their move away from primary care.Mind your pathology. It was Sir William Osler who wrote: “As is our pathology, so is our practice.” It’s a good reminder that the health system cannot function properly or well without significant investment in a diagnostic specialty like pathology. The speed at which the system can move depends, in large part, on having significant capacity and expertise in pathology. With Canada’s aging population, its importance will only grow. We have seen chaos in places like Alberta with constant restructuring of lab services. The public doesn’t appreciate the importance of pathology the way physicians do, so it’s incumbent on doctors to ensure these services are functioning well. Patients simply cannot afford a crisis in pathology.No more pizza in lieu of progress. There have been more reports this year about the toll of extreme duty hours on resident physicians. Coupled with more reports on learner mistreatment, and it’s not hard to see how high degrees of burnout in the medical profession will not perpetuate but possibly get worse. The public needs this intergenerational learned behaviour within the medical profession to end. Not only should all physicians, regardless of their training level, be treated with respect and free from mistreatment because it’s the right thing to do, but breaking the cycle will help physicians provide better care to their patients. Unwell doctors don’t make for well patients. So stop celebrating your trainees with pizza and instead make a change to celebrate them with better treatment.Stop being so frenetic in your advocacy. We can all appreciate that there is no shortage of issues that need addressing in healthcare. One would expect to hear physicians speaking about many of them. The public, though, is not well-served by how quickly medical associations seem to lurch from one issue-du-jour to the next. In a world where information is coming at decision-makers and the public like a gushing fire hose, it takes time, persistence, and a methodical approach to move the dial on any particular issue. Physicians and their medical associations have a platform. They need to pick issues that matter and pursue them for as long as it takes to make a difference. Patience is a virtue. Patients would be the benefactor.Remember that history doesn’t need to repeat itself. We’ve now seen multiple years in a row where pediatric and adult emergency departments have been overrun by COVID-19, influenza and RSV. We can quaintly call it a “season” all we want but that doesn’t help. In fact, it makes it worse. It implies that there is a natural beginning, middle and end over which no one has control. Nothing could be farther from the truth. Physicians taking to the media in mid-December doesn’t help. It’s like a firefighter yelling “fire” in the middle of a house already engulfed in flames. But just as human behaviour is messing with our actual seasons, it’s also messing with the so-called respiratory one. As much as we seem to have embraced collective amnesia about COVID-19, there is no denying it’s ongoing impact on people’s health and the healthcare system. The data related to long COVID is staggering. More acutely, though, there were (according to the Public Health Agency of Canada at time of writing) almost 4,700 hospital beds occupied by COVID-19 patients in Canada. Is it any surprise given Canada’s abysmal COVID and flu vaccination rates? Imagine having some or all of those 4,700 hospital beds freed up? Physicians need to be at the forefront of an effort to talk to patients proactively, advertise proactively, and advocate proactively, for people to take the necessary steps to avoid illness and death. This should be done on a rolling basis and ramp up months before a “season” could start, not a couple months after it does. Anything else will just see history repeat itself over and over again.Matt Maruca is a lawyer, communications expert and consultant. He is also an expert in physician compensation and spent a decade as a senior executive of a major medical association.

A layperson’s list of New Year's resolutions for physicians

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