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April 27, 2000


Academic physicians should be all 3: teachers, clinicians, researchers

To the editor:

I may have lied to my 6-year- old daughter. At bedtime the other night, she asked, "Daddy I don't know if I want to be a doctor, a teacher or a mother. Can I be all three?" I replied with a definite "yes" citing a number of colleagues, including several of her playmates' parents, who heal, teach and do outstanding research in their profession.

But, I may have to retract that based on the April 13 issue of the University Times. You quote Jeffrey Romoff as saying, "It is no longer feasible to do what academic physicians always thought and hoped that they could do, which is to be a good teacher, a good researcher and a good clinician. It's not only not feasible. It's actually bad."

Dr. Romoff asserts that in surgery I would want "the guy who's doing this [operation] five days a week [to the exclusion of research and teaching], who lives and breathes the procedure you're going through." Well maybe, if that is what makes him a better doctor.

But I also want him to be sure this is the best procedure for me and his is the best technique available. Furthermore, if he is indeed the 'best guy for the job' today, but if I need the procedure five years from now and he is unavailable, I want to be sure that he has transferred his skill to other competent physicians.

In fact, 20 years from now, I want that doctor — not the lab guy who never operates in the clinic because he was pegged as a "researcher," nor his colleague who was only a "teacher" — to have the freedom and the incentive to instruct my daughter so that she can be the best person for the job.

Perhaps giving our physicians more time to earn tenure is a step in the right direction. Perhaps the medical system needs to offer physicians more creative scheduling involving three-year rotations of research, teaching and clinic priorities. To be true to our mission, we must pursue ways to help willing physicians to achieve our vision of ourselves on an individual as well as corporate level.

It seems to me a great folly (however profitable it may seem in the short run) to resign ourselves to a vision of individuals who are either researchers, teachers or clinicians but not all three. We need to accept an integrated view of each academic physician: that he or she be a good teacher, researcher and clinician.

It's not only necessary, it's actually good. If we can't see our way clear to believe that, let's just call this the "PMC Health System" and give the "U" to a more daring institution that can offer a definite "yes" to our children as they look toward their role in the future.

Charles J. George


Childhood Depression Studies

Western Psychiatric Institute and Clinic

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