A general surgeon in the United States talks about his journey to medicine, the exhaustion of doctors and the future of medicine

The Yale University Medical School community gathered at Harkness Hall on September 9 to hear the Vice Admiral Vivek H. Murthy, MD ’03, MBA ’03Surgeon General of the United States, Department of Health and Human Services, speaking at 24The tenth The Samuel O. Thier Annual Lecture in Health Care Policy.

Hosted Grand Medical Tour Session, “A Conversation with the Surgeon General of the United States” Gary Fei Desier, MDHead of the Department of Internal Medicine, and its director Marcella Nunez Smith, MD, MHS, Associate Dean of Health Equity Research and CNH Long Professor of Internal Medicine (General Medicine), Epidemiology (Chronic Diseases) and Public Health (Social and Behavioral Sciences). Murthy and Nunez Smith, old colleagues who have returned to their medical residences, spoke about Murthy’s journey into medicine, the exhaustion of health care workers, and his thoughts on the future of the medical field.

“[Murthy’s] The work has provided clear, consistent and fair guidance and resources to the public.” Nancy J. Brown, MD, Jane and David W. Wallace, Dean of Yale University School of Medicine and Professor of Internal Medicine at CNH Long. “His work has focused on key public issues, including the prevalence of misinformation as a real problem in the past two years, the ongoing youth mental health crisis, and the well-being of health care workers.”

“It has been a great honor to work with Dr. Murthy during the transitional period and the first year of [Biden] “Management on the federal response to COVID-19 and the promotion of health equity at scale,” Nunes Smith says. “I am so grateful that he was able to join us in the conversation to highlight the critical work of the Surgeon General’s office and to bring an inspiring perspective to the next generation of healthcare business and leaders. He is a national treasure.”

A non-linear journey into medicine

Murthy’s inspiration to become a doctor came from his parents, who ran a medical clinic in Miami. But his path was not linear. While undergraduate at Harvard, he pursued interests in history, economics, and literature, but eventually returned to the world of health when studying HIV and felt the same sense of inspiration he had as a child watching over his parents. the clinic.

Murthy went on to earn a master’s degree in medicine from Yale University School of Medicine. However, by the end of his residency in internal medicine at Brigham and Women’s Hospital, he realized he didn’t know what he wanted to do. He decided to take a part-time job as a hospital doctor while trying to figure out his next steps. He kept a yellow sheet of paper with him to keep track of his thoughts – many of them ended up in the trash. He says it was a “difficult, confusing and lonely time.”

“I was really lost. Everyone else found out — they were going to apply for this fellowship, or this primary care job,” he said. “I was one of those people who didn’t.”

Finally, in 2007, he felt his passion on fire again. When presidential candidates began preparing for the following year’s elections, both sides were actively talking about health care. Despite his lack of background in health politics, he saw firsthand as a physician the burnout and cynicism many of his colleagues felt toward the health care system. He became interested in becoming part of the ongoing conversations and working to make things better for health workers.

When reflecting on his journey, Murthy offered many advice. First, he said, is the risk — we often tend to value risks as greater than they are. His second tip was to think short term rather than long term. While it might seem wise to have a five or ten year strategy, he explained, most successful people end up walking away from their initial plans. Finally, he advised audience members to stick with their reporters.

“None of us can walk these paths alone,” he said. “We all have moments of doubt and doubt. And in those moments we need other people who can be our mirrors and remind us of who we really are and what our values ​​are.”

Managing health care worker fatigue

In May, Murthy released a file General Consultant of Surgeons Call attention to the depletion of health care workers. He hoped to identify a path through which his team could address this problem and help the public understand the severity of the crisis. “We got here through a series of policies, institutional practices, and cultural elements that have all contributed to where we are now,” he said. “But we all have a part here [in addressing burnout]. “

Murthy hopes to lighten some of the burden by working to change the culture of medicine in a way that redefines strength. Traditionally, many health care workers have felt pressured to hide their struggles and feelings of uncertainty. He predicts that the medical world will shift to a culture of compassion, in which organizations value how caregivers care for patients and their families within the number of hours they can work.

“Our promotion systems are based primarily on publications and grants, and much less on compassion, kindness and bedside care,” he said. “This is not a culture that supports the well-being of physicians, and it certainly does not help patients. So we have to take a hard look at the culture within our training programs and our health systems and make sure that it reflects the kind of culture that fits our doctors and the work they do.”

Reflections on the future of medicine

It is not easy to be a doctor. As crisis after crisis creeps into the media headlines, it can be easy to get frustrated. But the people Murthy works with keep him optimistic about the future of medicine. “The reason I’m optimistic,” he said, “is that our true nature is not to quarrel with each other.” “Across America, I see people who wake up every day asking to be part of making things better.”

He was particularly inspired by the many medical school students who came forward at the start of the COVID-19 pandemic excited to come up with solutions. That leadership and commitment to making a difference, he said, is what the United States needs to address the issues it faces, including climate change, poverty, and racial inequality. He hopes to see more health care workers at the forefront of conversations about these pressing societal issues, and raise their voices with “strength, trust, clarity, and compassion.”

“Whether the world changes in the future for the better or not depends on how bright your light is,” he said. “It depends on how well we help each other.”

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