Do you think surgeons, anesthesiologists who don't care about people...

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TheBiologist

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Surgeons, anesthesiologists, emergency doctors or anyone who routinely sees patients (or operates on patients) who could soon spiral down to death probably feel stress in many situations because they don't want their patient to die

but do you think a doctor/surgeon who did not care about people or did not have a conscience would not feel stressed when things spiral? and do you think that this would actually make them better at what they do?

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Surgeons, anesthesiologists, emergency doctors or anyone who routinely sees patients (or operates on patients) who could soon spiral down to death probably feel stress in many situations because they don't want their patient to die

but do you think a doctor/surgeon who did not care about people or did not have a conscience would not feel stressed when things spiral? and do you think that this would actually make them better at what they do?

I'm sure they exist, but I've literally never worked with a surgeon (n > 20) who didn't care about their patients. Even the biggest douche bag dingus surgeon I've ever met still got stressed when things started to go poorly.

And no, I don't think it would make you better to be a robot. Have you ever heard of Yerkes-Dodson?
 
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I’m not sure a doctor that didn’t care about people or have a conscience would be able to effectively treat their patients. I think such a doctors outcomes would suffer.
You really need a mix of empathy and emotional distance to be effective.
 
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From the doctors I've worked with and shadowed, no matter how jaded they may become over time, they still care for the well-being all their patients at the end of the day. If you don't care about people, why go into medicine?
 
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I'm sure they exist, but I've literally never worked with a surgeon (n > 20) who didn't care about their patients. Even the biggest douche bag dingus surgeon I've ever met still got stressed when things started to go poorly.

And no, I don't think it would make you better to be a robot. Have you ever heard of Yerkes-Dodson?
At the same time with the complexity of the task at hand, caring about patients too much will have the same results as having no care at all (according to Yerkes-Dodson).
 
At the same time with the complexity of the task at hand, caring about patients too much will have the same results as having no care at all (according to Yerkes-Dodson).

Right, but repeated practice increases the amount of stress needed to get to that point. But generally, I agree with you. You have to care, but you can't be too attached. That's part of why they recommend not treating family and why none of the surgeons I know won't operate on family members.
 
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Surgeons, anesthesiologists, emergency doctors or anyone who routinely sees patients (or operates on patients) who could soon spiral down to death probably feel stress in many situations because they don't want their patient to die

but do you think a doctor/surgeon who did not care about people or did not have a conscience would not feel stressed when things spiral? and do you think that this would actually make them better at what they do?

"Caring" about someone's well-being is not the same as being emotionally attached to that. In this case what "care" really means is that the doctor hopes the best for the patient while at the same time being able to get done whatever needs to get done without letting pressure or stress hinder their productivity. Mental maturity allows one to distance their personal feelings (that can often be unproductive) from their actions.
 
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Surgeons, anesthesiologists, emergency doctors or anyone who routinely sees patients (or operates on patients) who could soon spiral down to death probably feel stress in many situations because they don't want their patient to die

but do you think a doctor/surgeon who did not care about people or did not have a conscience would not feel stressed when things spiral? and do you think that this would actually make them better at what they do?
No, because many times the live of the patient is mainly in the responsibility of that physician. Even if said physician does not personally care about that patient, the outcome of that patient is his responsibility. So the stress would be not because personally he feels for the patient's suffering, but because he may be failing to do everything he can as his duty as physician.

But this seems a bit contrived. Everyone has emotions and to feel empathy or sympathy for another human being is only natural. Even if you went into medicine for the money solely and couldn't care less about medicine or people, I think you would still be emotionally affected.

Can you give a more concrete example?
 
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Surgeons, anesthesiologists, emergency doctors or anyone who routinely sees patients (or operates on patients) who could soon spiral down to death probably feel stress in many situations because they don't want their patient to die

but do you think a doctor/surgeon who did not care about people or did not have a conscience would not feel stressed when things spiral? and do you think that this would actually make them better at what they do?

I'm going to limit myself to 15 minutes of typing. I am on call tomorrow and really should have gone to sleep an hour ago. This is obviously a complex topic and should be a book in and of itself, but let me try to do it justice.

For context, I am in the final stages of my 7 year vascular surgery residency. It is fairly rare that a month goes by that I don't personally care for someone who is about to die. Last Thursday, I admitted a patient with an infected endograft who after 3 family meetings, we made DNR/DNI and terminally extubated this morning. It was the first time that I was the primary talker in all of the family meetings. While I had faculty present in two of the meetings, it felt as close to my name being on the chart as I have experienced thus far. With that fresh experience in mind, here are my global thoughts:

#1 Physicians are humans. They exists on the spectrum of the rest of society. There is little that makes them 'different' or 'special'. Virtually every sub-set of physicians follows this same rule. Thus, surgeons, while they may have some stereotypical traits are more similar to the rest of society than most people think.

#2 People are selfish and egocentric. It doesn't matter what sub-population you dig up and while every population exists on a continuum, people are going to look out for their own interests over that of others. This is no different with physicians and patients. I would like to think that there is some 'ethics' or 'code' that would make physicians less likely to be this way, but nothing in my 10 years of exposure to medicine would lead me to believe this. I certainly have faculty that are angels, but if I look at the entire population of people that I know as "physicians" or "surgeons", their actions are modulated by what benefits them or impacts them to a significant degree. While it is easy to bash people for this, in my opinion, it is the norm.

#3 It is pretty rare to come across someone who globally "doesn't care about people". However, as in #2, the number that care about other people as much or more than themselves is rare.

With those three said and to answer the original question, there is a balance that is necessary to being a good physician. You can not get caught up emotions of death and dying while you are treating someone, obviously you will be less capable. But, by the same token, the number of times that I've seen delayed, inadequate or simply bad care stemming from physician needs trumping patient's is a dime a dozen. Most of the time I find that physicians (or others in healthcare for that matter) lie to themselves as well as the rest of the world. Sometimes it is by hesitating or deferring care. Sometimes it is offering less time/attention than is likely necessary.

Went over a little bit time wise. So I'll just end with the disclaimer. I'm pretty sure you could replace 'physician' with any other occupation and the same would hold true...
#Jaded
 
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Humoring this because why not I'm bored: What are the motivations of this hypothetical surgeon with no conscience to do a good job, if they truly do not care about the outcome for the patient? Even with a complete lack of empathy for the patient's suffering, they are still likely to become stressed if things go south for other reasons - maybe they see it as reflecting poorly on their skills as a surgeon, maybe it's bad for billing, idk. They don't have to care about the patients themselves to be stressed by a poor outcome/patient death.
 
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