Primary Care and Prejudice

EXPECTING PROFESSIONALISM FROM PROFESSIONALS

Whether you are currently pursuing a degree in a professional field or have already achieved that, you have probably been the victim of a pointless and frequently committed offense: the unsolicited opinion about your career choice. Outside of overly involved family members and frenemies who always have something to say, people seem more willing to offer an opinion to those pursuing a professional degree compared to the general population. Why professionals in training make such great targets for advice could be debated endlessly, but it is pretty clear that this practice is likely to elicit aggravation or mere indifference at best.

Let’s start with the general nay-sayers, often themselves practicing doctors, who will tell you not to become a physician at all. This advice is too little too late, and frankly, it insults the decision-making skills of the student and the institution who accepted the individual into their program. A current medical student has already committed a significant amount of time and work to this particular career path. Additionally, unless one of the lucky few, this student has accepted the responsibility of financial indebtedness. Considering these factors, it is unlikely that a student just woke up one morning and decided that being a doctor sounded like a fun thing to try. Even in such a case, I doubt that “capricious” and “lack of critical thinking skills” are descriptors that admissions teams are looking for in a prospective student. Clearly, the person giving this advice has forgotten the importance of knowing one’s audience.

There are also many people working in healthcare who will be supportive of your general decision to go into medicine. This scenario is great until that dreaded question is asked. So, what is it exactly that you want to do? This could be genuine curiosity, but unless your response includes the field of the person asking the question, any answer you give might be taken as an invitation for a personal diatribe about why X is better than Z. The futility of this exercise is what makes it so exasperating. First, there is almost never an attempt to understand a student’s reasons for considering a particular field, so the argument created is based on a lot of assumptions (e.g., your primary career goal is to own an exquisite collection of rare art and fine wines). Second, for a student in the pre-clerkship years, it is much more likely that gaining first-hand clinical experience will cause a change in opinion than an uncomfortable conversation with a person they may never see again. Finally, these rants are often predicated on a lack of respect for other fields, especially those in primary care. So, rather than convincing a student that a career in family medicine is unwise, this type of “guidance” is likely going to change nothing more than their opinion about the advice giver.

Of course, nobody enjoys receiving unsolicited advice. However, it’s especially frustrating when the messenger is a healthcare professional with whom you must work as a student. While Mom’s advice might inspire some eye-rolling, she at least has some context as far as your personality, values, and previous experiences. And, unless she’s also your preceptor, there is little professional risk in voicing a differing opinion. I do value honesty and openness in discourse, but that requires both parties to be receptive and respectful. Keeping in mind that each person is driven toward a particular career by unique interests, experiences, and goals might help shift such conversations away from paternalistic recommendations and towards something more productive, such as building a relationship with room for future collaboration.

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Ashley Jones is entering her second year of medical school at The University of Arizona College of Medicine – Phoenix. She plans to enter a primary care field after graduation and hopes to provide medical care in developing areas throughout her career.