Saturday, March 11, 2006

Practicing medicine----can we self-actualize?

First described by Kurt Goldstein, the notion of self-actualization was popularized by Abraham Maslow in his description of the hierarchy of needs. Simply put, the theory holds that along the path to achievement of one’s potential (self-actualization) is a hierarchical progression of prerequisite needs to be met.

R. Whit Curry, Jr, MD, Professor of Community Health and Family Medicine at the University of Florida, writes in the March 11 issue of Patient Care about the seemingly joyless struggle of practicing medicine. He challenges us to get past the “baggage” of the medical profession and self-actualize by focusing on the uniquely positive aspects: the satisfaction of helping and making a difference, the joy of learning and the privilege of glimpsing a fascinating slice of life.

But the hierarchy of needs is an obstacle course which can be difficult to ascend at times. The baggage of medicine can suck the joy right out of us; it gets in the way of the path to self-actualization. This baggage must be shed in order to achieve professional satisfaction. Maslow’s categories of needs have parallels in medicine: physiological needs (sleep deprivation, overwork); safety (looming threats of litigation and Medicare audits); love/belonging (patient complaints, critical colleagues, family stress, sense of isolation) and esteem (law suits, culture of blame).

These are difficult issues. The joy of practicing medicine (or self-actualization, professional satisfaction, call it what you will) can be elusive. Those who achieve it are of a special breed. Without a major cultural shift they will remain an elite group. (I wonder---can you blog your way to self-actualization?).

1 comment:

Anonymous said...

Perhaps those "special breed" of physicians who are able to self actualize are all academics like the Dr. Curry who are at least partially insulated from the baggage of full-time patient care. The rest of us facing a future of ever increasing expenses, shrinking reimbursement, pre-authorizations, and bureaucratic interference find it hard to see any joy at all.