Sept. 3, 2018

The Labor Day weekend is just about over, although the oppressive heat and humidity is confining me to the few air-conditioned spots in my house. It has been a hot summer; indeed, summers have been progressively hotter on average since I first came to New Hampshire in 1974. Climate change does seem real, doesn’t it?

In today’s blog post I want to continue the discussion of the AMA’s “Principles of Medical Ethics” that I began in my last blog post. The “Principles” are appropriate guides for all of us in our practice of medicine, but they are also good principles for the general function of everyone in work, relationships and even politics. 

Section 2 of the “Principles” states: A physician shall deal honestly with patients and colleagues, and strive to expose those physicians deficient in character or competence, or who engage in fraud or deception. 

Section 3 of the “Principles” states: A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.

As I extrapolate these “principles” to society in general, I am struck, of course, by the lack of honesty and truth in the realm of political discourse in our country these days. This seems especially the case on our national scene, with our current president ignoring truth and honesty, and his party in Congress refusing to exercise their responsibility to provide an appropriate “check and balance.” We are a country governed by laws, but if the politicians who make and enforce the laws engage in dishonesty, fraud and deception, what will happen to our democracy? As physicians, we are required to expose colleagues “who are deficient in character or competence, or who engage in fraud or deception.” We need to make sure the politicians we elect are committed to those same principles of honesty and truthfulness.

These “principles” are also pertinent to us as physicians in this era of “physician burnout.” Physicians used to be in charge of our practices and our schedules, so we had control of our professional lives. For most physicians these days that is no longer the case. Hospitals and corporations now own most of us, and they now control our practices and schedules. I suspect that “physician burnout” is a product of the loss of that control over our lives and our practices, leading to schedules that are often “contrary to the best interests of the patient” and contrary therefore to our best interests in our practice of medicine. When doctors are pressed to “cut corners” with our patients we end up dissatisfied with ourselves in our practice of medicine, leading to what we have come to describe as “physician burnout.”

I will have much more to say on the topic of physician burnout in an upcoming article in the NHMS Physicians' Bi-Monthly. Wendy Cohen, MD, a Board Certified Psychiatrist and Evaluation Director of Massachusetts Physician Health Services will also be presenting a talk entitled “Curbing the Epidemic of Physician Burnout” at the NHMS Annual Scientific Conference at Wentworth by the Sea in New Castle, NH. The conference runs from Friday afternoon, November 9, through Sunday morning, November 11. Please consider joining us for this opportunity to meet with colleagues and friends to enjoy the camaraderie that is so often missing in our busy everyday practices. Details about the Conference are available at our website http://www.nhms.org/. Perhaps the lovely setting of the Wentworth may help a little with the burnout encroaching on us all! 

Let me add one final note regarding an issue dear to my heart, the effort to repeal the death penalty in New Hampshire. Briefly, the NH Senate passed SB 593 by a vote of 14-10 and then it passed the NH House by a vote of 223-116. SB 593 replaces the death penalty for capital murder in NH with life imprisonment without the possibility of parole. Governor Sununu, as expected, vetoed SB 593. As a result, there will be an attempt to override the Governor’s veto on September 13, 2018. The override requires a two-thirds vote in both the Senate and House. In order to be successful in this override attempt we will need to convince two Senators to change their votes. We will also need to garner support from two-thirds of the House. If this issue is important to you, please consider calling your Senator and representatives to express your opinion on this controversial human rights issue. New Hampshire is the only state in New England that still has the death penalty, that still thinks it is appropriate for our state to kill a poorly selected few “to prove that killing is wrong.” The names, addresses and phone numbers of our legislators can be obtained at http://www.nh.gov/.

As always, I appreciate feedback and conversation about my blog posts and any other issues pertinent to the New Hampshire Medical Society. I can be reached at lenkorn.md@gmail.com.

Regards,

Leonard Korn, MD

NHMS President