Sunday, May 8, 2022

What Makes A Good Doctor? The Answer Might Surprise You.

Many physicians understandably pride themselves on special skills or knowledge that they have acquired.  This is true of so many professions.  A lawyer is admired for her skill in the trial arena.  A musician is lionized for his virtuosic technique.  An athlete inspires his peers and the rest of us with his record-breaking accomplishments.

We have all heard of physicians who are renown for particular talents.  

You need an operation on the pancreas?  Here’s the guy you should see. 

Your Crohn’s disease is not responding? You should see my specialist who saved me from surgery!

Your fibromyalgia is on fire?  Have you heard of this new doctor in town who runs a fibromyalgia clinic? 

Obviously, a physician’s skill set is a critical asset in the practice of medicine.  Indeed, when a patient sees me, he comes with the belief that I have the training and experience to address his concerns. Usually I do, but not always.  It is very important for physicians to know which patients should be referred elsewhere. The best physicians restrict their portfolio to what they do well.  

As obvious as this is for doctors and other occupations, it can be challenging for many of us to recognize when we should divest ourselves from tasks that we routinely performed for years.  Some of us may not wish to admit – or might not even be aware - that we don’t have the same surgical skill and stamina that we had previously.  Or, we are prescribing the same treatments that were state-of-the-art years ago, but the field has since moved on.  If a doctor gives up performing a medical procedure, this may directly affect his income and marketability. 

Excellence means that we are excellent at everything we do.  This means that we either have to set aside tasks that we do not execute at a high level or raise the quality of our performance.  If 4 athletes are on a relay race team, and one of the runners is slow, the team will lose regardless if the other 3 runners race like cheetahs. 

To win the relay race, all runners must perform well.

Years ago, I decided to give up performing a complex gastrointestinal procedure for good.  This scope procedure investigated issues involving the liver and the pancreas and was technically demanding.  While I felt that I was competent, the field continued to advance and I felt that I just couldn’t keep up.  It can be very difficult for doctors to learn new and evolving technical skills when we are in practice as opposed to during our training years.  Had I continued on with this fancy scope test, my procedural competence would have surely eroded to a mediocre level.  So, I gave it up and never looked back.  From that point onward, I referred patients who needed this procedure to colleagues who were experts.  Everybody wins.

There are other examples of aspects of gastroenterology that I no longer practice.  It’s not important that I do everything. But I want everything that I do to be done well.

So, you may seek out a doctor for what he can do.  But an important aspect of being a good physician is also what he doesn’t do. 




  1. What makes a good doctor is truly caring about each patient as a person. The rest follows from that. You sound like a caring doctor. We had a CMO, who had a patient panel 80 percent male, because women would never go back a second time. He gave us a monologue about the "epiphany" he experienced when he realized patients needed you "to listen." This ass had been in primary care for ten years! Fortunately for patients, he now has the highly paid position of bossing around a huge group of (mostly female) NP's. If skill levels are equal, I would always refer to a specialist with like you, who had the patient's best interests at heart.

  2. Judy, thanks so much for reaching out. I follow your point about the CMO exactly. For myself, improving my doctor-patients relationships will always remain a work in progress. If a patient expresses disapproval to a doctor, this can serve as a fertile opportunity for the physician to self-reflect rather than to assume a defensive crouch.