Knowledge and Wisdom: Pass It Forward

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Commentary — November 2015

Tex Med. 2011;111(11):15.

By Lawrence F. Buxton, MD

I have practiced neurology for 40 years and am still going strong. Retirement would not be a palatable option. I hope along the way I have acquired sufficient knowledge in my specialty and I have gained wisdom.  

Wisdom and knowledge are different. Wisdom has been defined as "the soundness of an action or decision with regard to the application of experience, knowledge, and good judgment." In contrast, knowledge has been defined as the "facts, information, and skills acquired by a person through experience or education, the theoretical or practical understanding of a subject." 

I recognize the difference. In the practice of medicine, one could appreciate the paraphrased Chinese proverb: if you could only put an old man's head on a young man's shoulders. 

I wonder what happens to the wisdom and knowledge acquired by physicians when they retire. Do these valuable assets float around their brains in neural networks until amyloid excess renders them useless? What a terrible waste — huge amounts of valuable tools that could continue to be used. One day, the physician is wrestling with a difficult differential diagnosis, and then on the first day of retirement, he's driving back from errands at Wal-Mart looking forward to the U.S. Open. 

What if that physician could retire and continue to use his knowledge and wisdom in a most meaningful way — to improve the current state of health care in Texas? Let me pose an embryonic idea. We (the physicians of Texas) could organize a consultation service composed of retired or semiretired physicians who could provide brief consultations to health care professionals (young physicians in practice, nonphysician practitioners, and others) by telephone, fax, or email throughout the state. 

A roster would be created by medical specialty or subspecialty, listing the names and contact information of members of the group. A group such as the Texas Medical Association could circulate the roster to members. We could create time schedules so callers would know what days and times consultants are available. 

The concern of medical liability looms in an ominous way. Even though the Consultation Service (a possible name for the group) would be done on a charity basis, it would not lower legal exposure to its members. Discussions with TMA and the physician members of the Texas House of Representatives and Texas Senate would be in order. Communication with the Texas Medical Board would be enlightening, as well. Sea changes in the laws may be needed for this kind of program to be feasible. 

I don't know the experiences of my colleagues dealing with young physicians and nonphysician practitioners, but my experience is that they are all crying out for help, guidance, and thoughtful backup for their patients. Often, the challenging patient is sent to the local emergency department. That action often just increases costs. 

In the meantime, the huge amount of knowledge and wisdom possessed by retired and semiretired physicians is being squandered and wasted. What a waste for the human condition and the human spirit. 

The question one should ask about the embryonic idea discussed above is not why but, rather, why not?

Lawrence F. Buxton, MD, is president of the Burnet-Lampasas County Medical Society and a delegate to the Texas Medical Association.

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May 25, 2016