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In Medicine, Always Bring Your 'A Game'

— Top-level performance is a requirement for the job, says Suneel Dhand, MD

MedpageToday

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I was having dinner with somebody not so long ago, and the conversation turned to what life is like as a physician. I always find it interesting to have these conversations with people who are not in the medical field, especially those who have got their ideas from watching medical shows on television! The person I was speaking to on this occasion, however, wasn't about to go down that route, despite being in a completely different industry. What was said to me was something entirely different that took me a bit by surprise. It went something like this:

"I remember shadowing doctors when I was in college and spent a lot of time with them in different specialties. I have to tell you that I considered many careers and got lots of work experience, but I don't think I've ever seen a profession where anyone has to be on their A game all the time as much as doctors do!"

I asked for some further explanation and was told about how impressive it was that doctors worked in such an intense field, constantly on the go, and how there was no room for being less than completely engaged in what they were doing. The phrase "being on your A game" traditionally applies to sports, where players and athletes have to be at their peak whenever they are on the field.

This statement made me think and reinforced to me something everyone in medicine already knows. We work in a tough and all-consuming arena. There are always a hundred things to do when you are in the "zone" of patient care. Everyone expects you to be at your best -- other doctors, nurses, and most of all, of course -- our patients. We can't go out and take a long walk outside, retreat, and sit quietly in our office whenever we feel like it, or get regular periods during the day when we can calmly "switch off."

I vividly remember reading something in a careers advice book when I was 16-years old in high school in England. It was a paragraph on being a doctor, and the last line read: This is a physically, mentally, and emotionally-demanding job. All these years later, I can see how true that statement was. It's the job description, no matter where you are. This profession is indeed not for the fainthearted. We are dealing with life and death issues and meet people at very emotional and typically low points in their lives. Every patient, family, and staff member will acutely remember their brief interaction with you -- and our performance and demeanor will reverberate in ways we often don't realize.

As I think about the trust that's placed in us as well, it really does ring true. We may work in a suboptimal and fragmented healthcare system, have terrible computer systems foisted upon us, and get bogged down in administrative work that makes us want to tear our hair out. So many physicians out there are jaded. But as ultimate professionals, the show must always go on. When it comes to patient care and what the general public expects of us: Being on our A game is where we always need to be. No matter what.

is an internal medicine physician, author, and an independent health care experience and communication consultant. He is co-founder at . (link: )

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