Looking for the perfect doctor?

There’s been a lot said by me in this and by others in other forums about what modern medical doctors should and shouldn’t do or be — and this is an essential debate — one that needs to be held as the medical profession adapts to rapidly changing technologies, demands and expectations.

So I thought it would be helpful to try and define the perfect doctor — what qualities and attributes would that doctor have? Let me say right at the start that this person is, as we will see, by necessity fictional!

Here we go — important qualities for the perfect doctor:

Knowledge — the perfect doctor should know everything about everything — an impossible task. If not actually knowing the information, knowing where to find it is a reasonable alternative, but even that is difficult, bearing in mind that the quantity of medical information doubles every five years, much is contradictory, flawed or open to interpretation, and that old, established knowledge changes surprisingly often. And the updating and refinement of knowledge must be immediate for our perfect doctor. This means keeping up to date with every journal as it is released — each one of the 5 000 biomedical journals out there … about 15 journals and 150 articles every day …

Experience — the perfect doctor should have comprehensive experience, because knowledge alone is not enough. By definition then, young doctors cannot be perfect. When then, if ever, is the level of experience “enough”? And while time spent in a career increases experience, other factors like learning ability, coordination, fine motor control, mental agility suffer … and our doctor becomes less than perfect.

Availability — the perfect doctor should be available to his patients all the time. Weekends and holidays off are not acceptable. Even going home at the end of the day implies being unavailable to someone in need. So, being on duty 24 hours a day seems to be a prerequisite for perfection. Sleep is an unaffordable luxury for the perfect doctor. And patients should be able to see him/her immediately. Without waiting …

Family commitments — no! There’s no time! Doctors need to be available, remember!

Family experience — at the same time however, the perfect doctor needs to understand the dynamics of being a normal human being functioning under normal stresses, and it seems logical to expect our doctor to be a family person with real life experience, or an equivalent … oops, big conflict with the previous item here!

Cost — issues of money ultimately corrupt most things. The perfect doctor simply cannot have anything to do with financial considerations — they should not be involved whatsoever. This implies having unlimited access to tests and treatment options for his patients. Failure to have this means practising imperfect medicine — something our perfect doctor cannot do. But at the same time, the practice of medicine must never be wasteful, given that money available is always limited, and overspending in one area will compromise another — hurting patients. No room for that in the perfect medical career! Another consideration is that the business practice behind medicine is as susceptible to underhand, perverse or crooked practice as in other industries, and our perfect doctor should be aware of all issues, right down to the ethics behind procurement and cost of every tablet, needle and swab. Good luck with that one!

Consistency — our perfect doctor should never have a bad or off day, never be ill, depressed, or burnt out. Nor annoyed or worried about or by patients. Of course, having perfect patients would be a great help to our doctor …

By this time, we probably all should agree that the perfect doctor by these criteria is an impossibility, a fictional character. I fail terribly on all of these points, to the extent that, subjected to a test, I would probably be lucky to pass at all …

And yet, I don’t think I’m bad at what I do, feeling about myself as do the majority of doctors. Very human, far less than perfect by these standards in many fields. This makes me think that the criteria for being perfect here are meaningless.

Being a “good” or even “great” doctor depends more on qualities that are intangible and irreducible.

Like being a “good” human. It’s that simple in theory. And just as difficult to put into practice.