Remembering What It Means to Be Called “Doctor”

The guest editorial that follows is a transcript of the commencement address delivered in May 2014 to the graduating seniors at the University of Texas Medical School in Houston by the president of the Harris County Medical Society, Dr. Elizabeth Torres.¹

I find Dr. Torres's remarks to be pithy, perspicuous, and powerful, and I agree with her sentiments completely. We at the Texas Heart Institute Journal are pleased and proud to make her thoughts available to our readers around the world. Although her message is specifically designed for newly minted doctors, it serves as a timely reminder for all of us.

Herbert L. Fred, MD, MACP, Associate Editor

My position this year has afforded me many different experiences, but none so humbling as speaking at the University of Texas Medical School at Houston graduation at the end of May. What could I say to the new graduates? I certainly did not want to focus on SGR, the Affordable Care Act (ACA) or ICD-10. These are transient issues, and certainly, not issues that matter at the core of why we became physicians. So, it made me reflect back as to how we got here; and why we are still practicing medicine. It's easy to lose sight of taking care of patients with the weather-like changes that swirl around us. One of the most important aspects of medicine is lifelong learning, keeping up with the science of medicine and the technology that helps us take care of patients. I don't think any other profession has to sort through the volume of information as we do in medicine. Most importantly is how we bring together what we have learned and apply it to individualize our patient's care. I want to share this speech with you. Please use it as a reminder of why we started on this path, renewing our commitment to the art and science of medicine and patient care.

Good afternoon, distinguished faculty, administrators, honored guests, newly minted doctors, and family and friends. I am honored to stand before you on this most auspicious occasion, and grateful for this opportunity. Congratulations to the graduates and their families from the 11,500+ members of the Harris County Medical Society. This momentous occasion marks the completion of the first stage of your medical training and demonstrates your commitment to lifelong learning.

As you look forward to starting your residency, I want you to reflect on how you have grown and what you have learned in the last few years. I want you to remember the joy and exuberance you felt starting medical school and use that same energy to drive you through residency. This is where you learn from your clinical faculty to bring together the art and science of medicine.

Share your passion for medicine with your colleagues, as this will help buoy you through any difficult times. Share your compassion with your patients and be generous with your time and attention. Remember that your patients are someone's dad, mom, brother, sister, husband, wife, or friend. Treat them as you would want your family cared for. Share your smile, laughter and human touch, as healing can start even without medication or technology. Sometimes it is all you have to offer.

As physicians, it's our job to listen attentively, examine thoroughly, and deliberate our plan thoughtfully, translating that information to patients. It is important that we gain our patient's trust by showing them their medical care is our top priority. The training of a physician is unique in both the amount of our knowledge base, which starts in medical school, and the time we spend refining that knowledge as well as the many hours we spend actually caring for patients before we can go out on our own and care for the sickest of patients.

Although we are part of a team, we cannot be replaced by any other member of the medical team. We are the team leaders. Our team members are very important. We each have our duties. And, they do overlap so as to prevent errors or oversights in patient care. However, physicians are the leaders of the medical team and responsible for directing medical care. We are not data entry clerks, neither are we slaves to guidelines or merely an extension of our electronic health record (EHR). The importance of our cognitive skills, which we utilized to formulate a plan for patient care, cannot be minimalized nor should it be undervalued. Patient care is much more than the sum of lab values and a CAT scan or X-ray reports.

Health care is personal. And, patients expect individualized care. We are in a unique position to deliver that care. Patients also have a responsibility to participate in their own health care. We need to give them direction on how to do that. It is the role of the public education system to help improve literacy and give a baseline knowledge of anatomy and physiology, so patients can better care for themselves. And, it is the role of society to decide how to pay for health care and for physicians to decide how to best deliver that health care.

As new physicians and leaders in training, you need to help forge the future of medicine. Your recent experience in medical school and your upcoming residency will give you the knowledge to help shape the future for that level of training. Over 90% of Texas medical students participate in organized medicine. By participating in organizations, like the Harris County Medical Society, the Texas Medical Association and the American Medical Association, we can all help educate legislators on health care issues and help direct legislative efforts to improve the care and safety of our patients, keep physicians in charge of patient care, and help preserve the doctor-patient relationship. These organizations also help us navigate the business aspects of our medical practices, so we can focus our time on patient care. Congratulations again. And, may I be the first to call you Doctors.