Bohn D. Allen, MD: Installation Address

Isn't it great to be an American!  Isn't it great to be a Texan!  And, isn't it great to be a physician!  There is no more gratifying, rewarding or exhilarating profession.

Tonight is a special time for me, for Mary Grace and for our families.

Who would have ever dreamed that a boy from a small West Texas town would become a physician, much less the President of the Texas Medical Association?

I am truly humbled by this honor.  I thank you.

Undoubtedly the two most important events in my life were the day I married Ann almost 46 years ago, and the day I was accepted into medical school.  Those two events have framed my lifetime in medicine.

Although my wife, in the course of 46 years, has spent many lonely hours and days separated from me, she has always remained my partner and my loyal and ardent supporter.

When I was often absent, she raised our children to be the outstanding individuals, citizens and parents they are today.  For that, I am forever grateful.  She will always have my enduring love.

I have been so honored to be a physician, to be given the privilege to care for my patients over these many years.

I can think of no profession more noble.

Hippocrates said in his admonition to the profession,

"Sometimes give your services for nothing and if there be an opportunity of serving one who is a stranger in financial straits, give full assistance to all such, for where there is love of man, there is also love of the art."

Truly a noble cause.  It applies today as well as it did over 2000 years ago.

As we move into my year as President, I intend to try to move us back toward the traditional virtues that brought all of us into medicine in the first place:

 

  • Dignity.
  • Honesty.
  • Sincerity.
  • And Simplicity.

DIGNITY

The first is DIGNITY - worthy of esteem or respect.

For many years now, the government, insurers and employers have tried to relegate us to a generic group they call providers.

They have sought to categorize us as businessmen.

Even worse, they have tried to insert themselves between us and our patients, but they have been unsuccessful.

The patient-physician relationship is one of the most sacred relationships two individuals can have.

Patients will reveal things to their physicians that they will not share even with their spouse or parent.  It is an intimacy unlike any other we know in society.

For that reason, those who would try to intervene must observe from afar; never being allowed to participate.

This is the precise reason that sacred relationship will endure any assault.

We, the physicians, must never violate the trust of our patients.  If we do, we lose everything.  We will be nothing!

We will be at the mercy of those outside of medicine, without esteem or respect.

HONESTY

The second is HONESTY - the integrity of who we are and what we represent.

We must steadfastly guard the integrity of our relationship with out patients by always being truthful with them and with ourselves.

Nothing will destroy the trust of a patient faster than untruth.  Truth is the foundation of the relationship.

Likewise, we must always be responsible for what we do.  There is no place in medicine for obfuscation or for shirking our responsibilities.

Responsibility is the hallmark of what separates physicians from all other professions.

The patient puts his life in our hands. We must never waiver.  We must remain steadfast, loyal, responsible and true to our calling.

SINCERITY

The third is SINCERITY - genuine and free of duplicity.

Sincerity is perhaps one the quality a patient most looks for in a physician.

It is important that patients truly believe their physician cares for them.

Dr. Richard Cabot, a noted early clinician, concluded that clinical competence must include not only mastery of science, but appreciation of the personal and social needs of the patient.

He taught that "the care of a patient is in caring for the patient."

We must always hold our patients' physical and emotional needs foremost in our minds.

SIMPLICITY

The fourth is SIMPLICITY - free from affectation or pretense.

In the sacred contract we have with our patients, when they are ill and the most vulnerable, we must never be condescending or artificial. We must never show pretense.

We must be natural, straight-forward and helpful.  Patients appreciate being dealt with directly.

Simplicity - free from affectation or pretense - strengthens this most revered relationship.

  • Dignity.
  • Honesty.
  • Sincerity.
  • And Simplicity.

These are the four virtues of traditional medicine that we inherited from the Greek and Roman physicians.

We must defend them rigorously with our hearts and with our souls.

If not, we become simply tradesmen, businessmen or providers.

We must always defend the moral high ground and never let our integrity be diminished.

As we have been forced away from the practice of medicine as an individual art governed by our moral and ethical dedication to our patients, we have been strangled by third party regulation - whether government or private - an arcane reimbursement system and a civil justice system that punishes even the most well intentioned actions of physicians.

It is as if Dignity. Honesty. Sincerity. And Simplicity - these traditional values of medicine - have been ignored, and now a hoard of vultures loiters at the alter of medicine … waiting to pick us apart.

Today we expend so much time and effort navigating the health care delivery system with its multitude of regulations and intrusions, we have little time left to care for our patients.

This is not what physicians should be doing.  That is not what medicine is all about.

Physicians are so exhausted and frustrated by the current system that is has sapped our will, our desire, and our spirit.

Many are left with a dim view of the future.

But not all is lost.  Let's look at where our mandate to care for our patients came from. It is based on the moral and ethical view of humanity.

Hippocrates in his oath commanded the physician "to come to a patient only for the benefit of the sick and to heal."

That is the bedrock upon which the practice of medicine stands.

It represents our moral obligation to do what is in the best interest of our patients - always.

That is the oath we all took.

If we look at Luke 10:29-37 , we see that medicine was founded on the principle of the Good Samaritan, which enjoined compassion with non-discriminatory service to those in need.

It embedded in medicine forever the value of compassion.

These moral imperatives were further codified in the Prayer of Maimonides, a Jewish physician and philosopher of the 12th Century.

The precepts of this prayer further defined the moral mandate to physicians.  They are:

 

  • Keep a clear mind when attending a patient
  • Avoid the delusion you can cure all things
  • The art is great; the time is short
  • See only the patient as your calling
  • Trust in the almighty to see you through

Hippocrates further states in the oath:

 

"If a physician does these things, may he:

 

  • be granted enjoyment of life and of his art, and
  • be honored for what he does

 

If he transgresses, may the opposite be his lot."

Through the fraternity of medicine which each physician must pass, a lifetime of dedication to education, learning and training in required.

Once a person has traveled this long arduous road to become a physician, one becomes a part of a brotherhood and sisterhood that no one but a physician can appreciate or understand.

There is a bond formed which transcends all others.  It is a bond, much like the threads of fine cloth, that holds us together in good times and bad.

Physicians today are consumed by endless paperwork, by administrative hassles, by bureaucracy, by professional liability threats, by inadequate reimbursement, by limited access to patients, by impersonalized processes and by burdensome documentation.  All in the name of controlling cost.

Although we want to be efficient, cost conscious, resourceful and provide our patients with safe quality care, it is not our job to contain the global cost of health care.

Our job is to care for our patients and get them well!

Sir William Osler, the father of Modern Medicine, reminds us,

 

"Medicine is an art, not a trade, a calling, not a business: a calling in which your heart will be equally exercised with your head."

No matter what system we ultimately evolve into, we can all take refuge in this: there is no more gratifying or rewarding experience than to take care of someone who is sick or injured and to know that what you did healed them or made them whole again.

That is the reward for being a physician.  No one can ever take that from you.

That is the essence of being a physician.

As we go forward, I hope we can overcome the frustrations, the cynicism and to some degree the apathy that exists today.

I pray we can strengthen our sense of pride, professionalism, dignity and our healing relationship with our patients as we move forward this coming year. I pray that we can recommit ourselves to those traditional virtues: Dignity. Honesty. Sincerity. And Simplicity.

I pledge to you my full effort in these endeavors.  I hope I prove worthy of the trust you have put in me.

God Bless all of you.

 

 

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