A
Novel Thought?
Hospital turns toward service
Response prepared to national medical errors report
OUR SELF-WORTH
by: Martin I. BRONK
I witnessed the recent plunge of the U.S. stock market with a strange mixture of dread and satisfaction. On the one hand, any of us who has trusted a portion of his financial future to a stock portfolio received a chilling reminder of the volatility of that investment. On the other hand, the shake-up of the magical New Economy somehow seemed morally just and long overdue.
As physicians living in Silicon Valley, we have watched our medical lives become increasingly "managed," progressively less compensated and generally more unstable. At the same time, the myriad of high-tech entrepreneurs (or secretaries to entrepreneurs) who surround us have been overwhelmed with opportunities and seem to be drowning in newfound riches.
In this environment, we are forced to acknowledge that traditional value systems have been realigned, if not totally reconstructed. Whereas conventional wisdom taught that a person could be assessed on the basis of his or her contribution to society (or at least to the bottom line), the measure of meaning now frequently devolves to a theoretical construct conjured up by a group of potential investors.
The drive of this unmanaged technology marketplace has led to bizarre and irrational appraisals: companies regularly achieve astounding capitalization values long before they have produced a positive balance sheet and often in the absence of any viable product. The workers in this arena place themselves on an ever-accelerating treadmill where returns often seem totally capricious but where big winners are rewarded in obscenely grandiose terms.
On the other side of this New Tech Divide resides much of the rest of humanity - the people who work at jobs in more mundane industries and those who provide the basic human services that form the bedrock for our lives.
Medicine has become a prime example of distorted and changing valuations. At the same time that advances in biotechnology allow us to provide ever more sophisticated and effective treatments for our patients, the overarching forces of the current economy continue to constrict us. In this rarefied "Valley" in particular, we are finding it more and more difficult to maintain ourselves. Evidence of the problem exists at every level, both for medical practitioners and for all the other health workers and support staff who participate in providing care.
Focusing on physicians alone, we find that recruitment has become increasingly frustrating, as promising candidates for new positions (both inside and outside the University) are frightened away by the outrageously skyrocketing housing prices. For those who have become established here, substantial numbers find that the pressures of maintaining a practice become overwhelming, resulting in some moving to other parts of the country while others may leave medicine altogether. Indeed, one can argue that the attraction of medicine as a career has been significantly compromised because of such concerns, redirecting many capable individuals elsewhere.
How should we respond to the pressures of our strange circumstances?
First and foremost, each of us needs to reconfirm to him/herself the fundamental importance of our role as physicians and healers: that we do have a unique and irreplaceable task. Indeed, our significance transcends the immediate benefits we may offer in providing medical care, for our profession proclaims an allegiance to humanism that stands as an ongoing directive to the rest of mankind. In this vein, we have a duty to advocate for the health of mankind and support those systemic reforms that will make life more universally satisfying and full. Implemented locally, I believe we are entitled to challenge the leaders of our high-tech valley to identify how their companies can truly benefit the world rather than simply delight a group of potential stock investors. And even more to the point, we have the moral standing to call on the newly-minted wealthy to learn philanthropy as a fundamental value.
Yet our relationship to the exploding entrepreneurial world certainly is not that of disconnected moral compass-holders; we in medicine clearly are major participants in an important segment of the new technology and have benefited tremendously from it. For those of us who are so inclined, opportunities do exist to collaborate in the development and application of innovative ideas, and those opportunities are available both inside and outside the University's umbrella.
Ultimately, of course, our ability to maintain a positive vision within medicine relates to a myriad of factors. While lofty ideals alone may not provide us a down payment for a house or eliminate the cost of college for our kids, each of us determines how we value the benefits and burdens that present themselves in this remarkable milieu. Hopefully, those same motivations that directed us into medicine initially will allow us to maintain enthusiasm for our ongoing medical careers and give us the impetus to be a strong collective moral voice within the leadership of this unique "Valley."
