Live a simple and a temperate life, that you may give all your powers to your profession. Medicine is a jealous mistress; she will be satisfied with no less. 


One of my internal medicine attendings, Dr George Burch,  relayed this aphorism to us while we were in our first pre-clinical year at Tulane. The power of the medical education process is illustrated in the fact that I can still see myself in that auditorium watching this (seemingly very old) man offer this and the advice on how to counteract the siren call of medicine…”get a good book and sit under a tree and read.” 

Although we’d like to believe otherwise, Osler was correct. Being a doctor still entails a lot of study prior to completing training. Although the hours that are required in training for direct patient care are limited to 80 in a week, there is no limit to the amount of study time learners must put in to learn their craft. As a program director, I have tools that I use to assess student’s and resident’s medical knowledge and their ability to synthesize it into patient care. There is no substitute for study and preparation. 

Once out of training, physicians must maintain their clinical skills. They did so traditionally through meeting attendance, journal reading, and informally through conversations in the doctors’ lounge. Now things are more formalized with continuing education credits being offered for using the right tools to look up information regarding patient care, as well as our Board requiring us to take specialized instruction to maintain certification. 

All of this takes time. Internal Medicine specialists, when polled, reported spending about 3.3 hours per week on reading. The part of the evidence based practice incorporated into the new model of care in Family Medicine will require data input and physician and staff education. At this time, none of these efforts result in money into the physicians pocket (back to the mistress…) 

Why put up with it? Aside from the fact that it pays pretty well, I find that it really is an interesting way to spend a day. I get to work with people who occasionally want to be healthier. I get to learn about stuff in the news (and occasionally be in the news). Every now and again though, I pick up a good non-medical book and think about Dr Burch.