Physicians in Society

It is indeed true that physicians have and continue to hold a high status in society. This is something that can be seen in many cultures throughout the world and perhaps it's attributed to the fact that physicians play a critical role in being able to diagnose and aid those in need with regards to their health. A physician's rigorous schooling and training is highly admirable as it shows a sense of self determination and dedication to their respective field, that of science and health. They have committed their lives to serving the health care needs of others, saving lives and ultimately improving the well-being of others whether it be on a micro or macro scale. I believe that the degree of an MD does not solely grant him/her status and respect but its how he/she is able to communicate and interact with his/her patients that makes the true difference. Other health care providers such as nurses and P.A.'s are also highly regarded in society because of their unique position to changing and improving the health and lives of others. However, it is apparent that they do not hold the same status as physicians. Perhaps this is due in part to the fact that physicians have been looked upon as the ultimate authority, by many, when it comes to health care. Both nurses and P.A.'s must be supervised by a physician. The P.A. profession has only been around in the United States since the mid-1960's. As for nurses, their roles have been readily increasing throughout the recent years as have P.A.'s but historically their roles and scope of practice have been limited. I believe that teachers and public health professionals are also valuable members of the entire health care profession and are increasingly gaining more and more notoriety in the field. All in all, teachers, public health professionals, nurses, P.A.'s and physicians in the United States must work together to make a fine tuned health care system that we can all be respect and be proud of.

Yo Doc... Ya Gotta Help Me

"I've got a stomach ache;" "I don't feel too well;" "I've been having these symptoms a few times now, maybe I should see a..." I am sure many of you know how that sentence concludes - old Joe six-pack (if I may steal a line from the 2008 campaign) seeking comfort in the fact that a quick appointment, subsequent check up, and a prescription or two (if he's lucky) from the man in the tie and shiny white coat will fix things right up.

These innate inclinations to seek the aid of a physician are neither by-products of formal institutions that provide a thorough, challenging, extensive and expensive education nor notions that these "doctors" are successful, noble, caring, rich and intelligent. The answer is more evolutionary than revolutionary - a practice spanning centuries and millenniums that can stretch beyond logic and mere steps of diagnosis/treatment/cure into the realm of magic, prayer and nature. While skills such as nursing, physician assistants, and public health professionals undoubtedly have a vital role in shaping health care across the globe, these titles have not been etched into our evolutionary being and are not part of our "physikos" (meaning nature/natural; where the word "physician" is derived from).

The history of medicine is profound, to say the least. From prehistoric practices of herbalism as far back as 25,000 BC, to Egyptian and Babylonian medicine that dealt with the supernatural, first accounts of surgery and the introduction of texts for diagnosis and prognosis, to Greek and Roman practices, to modern medicine - the journey is a long one. Today, we have reached the "here" and "now," where gods and demons, plants and animals, faith and witchcraft, technology and experimentation have changed and transformed medicine over thousands of years. The high status of an MD which overshadows all other health care professions can be accounted for by this history; this evolution. The Darwinian argument would suggest that its high praise is deserving based solely on the fact that it was survival of the fittest, and the MD sliced and diced his way through the top over thousands of years.

Physician Status

It is rarely argued that physicians are highly respected in society. This is in part to do with their rigorous training. If you look at any career, respect is something that is obtained with education, experience, and expertise. Physicians are held to higher standard in all three respects; therefore, they are highly respected among societies members. Even within the general title MD there is some sort of hierarchical level of respect. A physician with a high level of training in a particular specialty may be regarded with more respect than a general practitioner. I think that the level of respect is directly related to the need for that particular field. People value their health, and physicians are primarily responsible for the health of individuals. Other health professionals aid in the process of providing health, but the physician is directly responsible for that individuals well being. For example, a nurse may draw blood, a lab my process it, but the physician is responsible for interpreting and creating a health plan based on those results. The liability lies in the hands of the physicians. I don't believe teachers and other health professionals are not respected. People appreciate the services of those individuals along with other service providers such as policemen, firemen, builders, etc. The difference comes down to the level of interaction. For each idividual, it is different, but for most physicinas play a critical role. We come into the world in their hands and we usually leave it under their care. I have read the physicians oath and I believe that the answer to all of the above questions can be found within it.

They definitely deserve it

I definitely believe that the reason why many doctors receive such a great deal of respect is due to the years of training it took to receive an MD. It takes 8 years of schooling alone to become a doctor and that does not include all the extra clubs, sports, tutoring, fraternities/sororities, volunteering, etc. they had to be involved with in order to "stand-out" from the others. Becoming a doctor requires a great deal of sacrifice and many people are aware of this which is why so many people avoid it. Not many people are able to study for hours, work long shifts, be on call, miss out on family events, or postpone vacations and be okay with it, which is why it's rare it find people who would like to live the life of a doctor. 

It's very hard for many people to trust others. Whether it's trusting someone to keep a secret, trusting they'll complete a task you ask of them, or trusting them to be someone you can depend on, it's always difficult for people to learn who they can and cannot trust. And yet, people trust doctors with their lives all the time, and very easily I should add. The second someone breaks an arm, they rush themselves to an emergency room to see an individual that they probably never met before and trust that they will fix their arm. However, someone hears an interesting piece of gossip and suddenly slows down and really thinks about who they can trust with this minor secret. I believe people are aware of this irony. They know that although they may get a doctor who doesn't really care about his/her patients, they will still fix their broken arm, heal their sickness, or even save their life.

Furthermore, I think that although nurses, physicians assistants, and public health professionals are respected, they are not respect nearly as much as doctors. This, I believe, does involve the amount of training that a doctor receives. People believe that the more education or training someone has, the more qualified they are, and the smarter they are so they would rather listen to a doctor than a nurse. Without offending anybody, I definitely think that if I was placed in a situation where a doctor, a physicians assistant, and a public health professional were all giving me different advice, I would listen to the doctor. I just think they would know better. And lastly, I definitely think that the high status is deserved because even if someone is a crooked doctor, they still went through 4 years of undergrad, 4 years of medical school, and how many extra years of training to get that MD.

The Deserved Respect

To earn the respect of being called an MD is a long and grueling process. A process that to overcome requires dedication to serving others. The road that leads to attaining the respect given to doctors is not an easy one. I personally admire a doctor for their dedication and commitment to learning and serving others. Doctors are trained to be very knowledgeable individuals, but I believe that it takes much more than that to earn the respect of being a great physician. A doctor should be able to relate to their patients and pass on their education to them. Doctors have to be able to think on their feet and use common sense to save lives on a daily basis.

Status is in this country is something that has been socially created. In society if you have money and power than you have high status. Doctors are paid well so they do possess the money and power which leads to their status. I however believe that money should not be the force that drives individuals to pursue a medical degree. We don't want a bunch of greedy doctors that dont care about the well being of others on our hospital grounds.

I do not believe that a physician should be valued more than the another health care professional such as a nurse or a physician assistant. I believe that all health care professionals should work together to accomplish the common goal that they share. One should not be viewed as more important than another, instead they should all be seen as an integral part to achieve health care. The work of one could not be done without the help of the other.

Defining Status

Status itself has its own interesting dynamic. There are many different "types" of status, if you will. Someone who has some higher moral status may be seen on a completely different playing field than someone who has some sort of financial status. That being said, it is vital that we understand or at least determine what type of status we are referring to when it comes to physicians. Perhaps it's a mixture of many. Perhaps not.

What is our societal definition of status? In the US we often associate money and fame with the characteristic of high status. Doctors have both. They're high paid and though you might not see them splashed on the pages of entertainment tabloids, they live in a type of career fame that is often romanticized from childhood. Little girls can dress their barbies in doctors uniforms and lawyer power suits and other occupations our society creates as socially and intellectually powerful and thus desirable, bearing some sort of dream-like quality. Young men too dream of being able to save lives and play the heroic dashing man who swoops in and brings people back from the brinks of death.

Pursuits of a medical career are often built up in our minds as being superior from a young age. For parents dreaming of a proud path for their child to take, it is a career that is respectable, financially stable, and requires intelligence. For the young dreamers it is a career that boasts of making a hands-on difference in peoples lives and in turn receiving immense gratitude and of course, some degree of higher status in society, proceed by the cashing in of a very favorably sized paycheck.

In essence what I am saying is that this idea of physicians holding a high status is something that is ingrained so much in the culture of our society that it is translated then into the upbringing of our children and etched into our minds as adults.

Is it deserved? As a whole my personal belief is that the conviction of medicine is an admirable one. However, I believe that though an entity itself may be looked upon as generally good and deserving, that does not mean that its means of operation deserve the same admiration, nor does it automatically make those working within it deserving of such high praise.

Point being, I think the concept of physicians having a higher status is so far ingrained in the hierarchy of our society that regardless of the situation with health care and continued negligence by physicians or the growing contributions of physicians assistants, nurses and the like, they will for many, many years to come (if not forever) remain memorialized in our societal conscious as those of a greater caliber.

What's so special about an MD?

The MD degree has been one of the most prestigious degrees for several years. The notion that physicians have a unmatched powerful curative ability has been cultivated ever since the creation of the degree. Certainly a rigorous 4 year curriculum stressing the concepts of the sciences has supported the idea that doctors are knowledgeable individuals. However, their ability to critically apply their knowledge and make crucial, life-saving decisions is what places doctors on a unique pedestal for a lot of individuals.
In recent years, the role of physician assistants and nurses has become increasingly important, but the ripples of their importance have not yet transcended from the medical community to mainstream society. Unfortunately physician assistants, nurses, and even D.O's do not get the much deserved attention and recognition that is rightfully owed to them. Part of that has to do with the fact that M.D.'s have been the sole characters on the spotlight of medicine for years. Certainly the high status is deserved to M.D.'s but it is inappropriate to say that an M.D. is more valuable or better for society than public health officials, PA's, and nurses. Hopefully in the coming years, society will begin to accept the hard work and important role that these individuals play in medicine.

Hats off to physicians

Both the training and the responsibility of physicians is deserving of the respect they are given. First, physicians have had to go through extensive and strenuous education to obtain their title. In a sense, it is hard-earned respect. Although many professions may have been preceded by years of considerably challenging education, few professions are comparable to Medicine in this respect. 

Second, physicians face huge responsibilities on a daily basis. People trust them with their lives. It would be counterintuitive for the society that entrusts them with the most sacred of possessions to not respect their opinions or choices when dealing with topics in their expertise.

Healthcare requires cooperation among all these fields.

Physicians hold a high status in society and among healthcare workers because of their dedication to their job. Acquiring an MD is no easy task, it required 4 grueling and expensive years of medical school (after the 4 years of college and highly competitive admissions process). Practicing physicians then go on to complete 3 or more (usually more) years of residency, which is a demanding job with high levels of responsibility, and minimal pay. Many physicians then go on to complete a fellowship (1 to 2 years) in which they further specialize. By the time an MD is actually done with all their training they are well into "middle age" have hundreds of thousands of dollars to pay back and still need to begin their practice as as attending. This account doesn't even consider the professional demands of being an attending, and personal sacrifices made in pursuit of this career.  

Physicians earn their high status through their years of dedication to the field, and for most it is deserved. When M.D.s use their degree for commercial marketing of unverified products this is of concern to the healthcare field and the lay community because it calls into question the respect we have for all physicians. 

This same respect is not given to nurses, physician's assistants, or public health professionals. I do not necessarily believe we need to give this group the same respect. But I do think that our society undervalues their contribution to healthcare, and much of this is due to the poor understanding of what they do, and how they have earned their credentials. I think it is important for the health community to highlight the importance of the inter-professional cooperation required of all these fields working together within healthcare. This would bring about more respect for all these fields as well as healthcare as a whole.  

High Status of Physicians

Physicians undoubtedly acquire an amount of knowledge and undergo countless hours of training like no other profession.  In the beginning of times, when medicine was far weaker and less technologically advanced, people gave doctors their utmost respect because they seemed superior on a topic that is so important to all.  As a result, I think this respect was carried through the decades and never thought of as wrong, unjust or even unearned.  Stemming from this, I think it naturally just became part of the health care system for nurses, physician assistants and other clinicians to fall below doctors on the totem pole of respect.  Not that I am saying I feel doctors receive too much respect from society and that other workers deserve less.  I just believe that this offers an explanation as to where the level of respect surfaced from.

I don't think nurses and physician assistants are given the same level of respect as physicians solely on the fact that people outside of the health care system believe that knowledge is key; so the only logical choice to have the answers would be doctors.  In regards to public health professionals and educators, they are not viewed as having a major part in treatment or prevention of diseases by the lay person.  The ironic part of this perception is that nurses and PAs are the ones doing all of the major back work that often times saves a patient in critical times because of their familiarity with the case.  Similarly, health professionals/educators are figuring out ways to prevent disease and change lifestyle habits of the public-all of the components that will keep the people out of the clinics, hospitals and doctors offices altogether.  

I guess what I am trying to say is that I understand why doctors receive such a high level of respect almost instantaneously.  They are extremely motivated, committed and passionate people serving a population that is extremely needy and critical.  However, I also believe that others in the health care system are unfairly receiving criticisms and less respect when their positions are just as important as a physician.  All in all, I think our system is transforming its mindset to a point where all clinicians and professionals will soon earn that respect among all lay persons; but I also believe that, for the present time, doctors are not wrongly given such a high level of respect and status among our society.

An Earned Respect

I don't feel that physicians are automatically respected just because of the two simple letters following their names. The letters MD are no greater than PA or RN; and MD even has less letters than MBA or MPH. It's not the title that helps doctors earn the respect that I, along with many others, feel they deserve. Rather, it can be attributed to their actions, their willingness to help others, and their commitment to upholding and maintaining a certain level of unspoken trust. Moreover, they are doing all of this with what is considered to be of utmost value at stake. One's life and health.

Sure, nurses and others in the health field are also dealing with lives on a day-to-day basis, but none do so in as intimate a manner as doctors. In the end, it is the physician who calls the shots, who assesses the situation and determines the problem as well as the most appropriate solution. It is the physician who is turned to when there is an urgent situation in which the two outcomes are life and death.

I'm not saying that the jobs and roles of nurses and physician assistants are not worthy of respect themselves, but rather that there is a definite hierarchy in terms of where they fall with respect to physicians. A lot has already been said about the years upon years of education and training, but I feel that is almost irrelevant. Let's be honest, lawyers go to school for several years as well, but they are perceived under a completely different light. I feel that it is, instead, the motive and the basic premise for which they spend these years training, studying, and preparing that sets them apart from most, if not all, professionals: helping others overcome injuries, battle cancers, and prevail against diseases. It is perhaps one of the most selfless professions that exists. However, it is one in which expectations are set very high.

Patients approach physicians expecting to recover. Anything else would be considered a failure. Essentially, physicians aren't allowed to fail. In what other industry, profession, or career can a minor mistake be the difference between life and death. Not one's own life and death, mind you, but another person's. Thus, there is an unspoken trust that is developed for one's particular physician. A trust that is often upheld; if it wasn't, a physician wouldn't have patients, as they would turn elsewhere for help. And when this trust is upheld, a patient begins to respect the physician, and the respect continues to grow as the physician continues to do what is expected of him or her.

The respect is warranted.

WHAT! if!

Ok, I am just going to be typing out whatever comes to mind, because thats what I feel like my blog would be like.  So basically what if this society has decided that since it costs so much to go to medical school, there should be certain privilges that comes with that, priviliges that others may not acquire?  I am not saying that the ability to prescribe medications is necessarily bought with the competion of medical school, but shouldn't those physicians have some one-upping over those who did not complete medical school?  If everyone had the same priviliges of physicians, then why choose to be a physician if everyone can do the same thing without having to go through all the trial and tribulations of medical school?  It is assumed that throughout all the years of education that a physician has endured and treaded through, that they have come out of schooling with a vast amount of knowledge, the type of knowledge and understanding of the medical field that cannot be attained otherwise.  Would you want your friend who lives next door, working at Blockbuster, to prescribe your medications for you, perform surgery on you, or give you your heart transplant?  If you answered yes to any of those questions, then you are quite the risk taker, and may not be so bright.  UNLESS, your next door neighbor graduated medical school before he/she got the job at Blockbuster!  I am not in any way well-read on the topic of the army or public forces, but let's just say that I was to RANK a line of officers who have done service for the country.  Even as a novice, I would most certainly give more respect to those who have accomplished more, and those who have proven themselves through years of service and shown their true talents in the field.  In no way am I putting down the lower ranking officers, but wouldn't you rather have the higher ranking officers lead you into battle, as opposed to the rookie who just got into camp?  I have to pay my respect to those who are battle-tested.  I feel that it is the years of training that truly builds the respect and high status of physicians, their battle tested years of school/labs/hours of blood, sweat, and tears, and their continual passage of tests, in more ways than just on paper, but in life =)

Status of Physicians

It is a common belief that MDs are "all knowing". This is a natural feeling because just like with any other occupation, going through rigorous training/education and meeting certain qualifications proves they are able to make better judgments and offer better advice in their specific area of expertise. As many have pointed out before me, society places a huge emphasis on the hierarchy of quality health care. And since MDs are required to have the most training, they are at the top of the hierarchy. Therefore having the highest status and demanding (in a way)the most respect. Because of this hierarchy, any advice offered by a nurse or a PA, is considered second class information and taken with a grain of salt.

In my opinion, the respect and status of MDs is definitely deserved, but I also believe that there are other under-used resources in the health field as well. Generally speaking, there is a certain level of trust that develops between Dr and patient that is absent in relationships with public health advisors and other PM professionals. This level of trust is often based on outcome of health conditions. Since preventative medicine is more of a long term commitment that usually produces gradual change over a longer period of time, positive results usually go unnoticed. On the other hand however, positive results of biomedical treatments are seen almost immediately, making the effect of the treatment more apparent. Also, MD measures tend to be much more invasive that cause extreme changes in health. Many think that the prescription of drugs or a simple operation performed by a Dr will be able to erase years of damage done to their bodies. And impressive results cause people to believe that Drs are not just life savers, but miracle workers.

every health care professions deserved to be respected.

Physicians have a high status in society. Even among other health care providers, an MD commands a certain amount of respect. If you want to sell any nutritional supplements or diet plans, having an MD support it gives it credibility. Why do they command such a high level of respect? Is it due to their training or their commitment to healing? Why isn't this respect given to nurses or physician assistants? Or to teachers or public health professionals? Is this high status deserved? Your thoughts?

I think physicians do earn the respect due to their hard works from undergraduate to medical school and to internships. They have learned many medical knowledge throughout their training and they are meant to train to be professional about medicine. Due to these facts, I believe MDs' informations are credible and deserved to have high status. However, I also believe other professionals such as nurse, physician assistants and public health professionals also deserved to be respect with their knowledge and background training. Nurses, physician assistants and public health professionals have also gone through many training, and getting into nursing program is also very rigorous and competitive. Nurses also learned medical knowledge throughout their training, and it is the same to physician assistants. Public health professionals might not learn as many medicial knowledge as nurses, physicians assistants and physicians do, however, they have mastered other kind's professions, such as, health education, epidemology, statistic, and communication. These kind's trainings are not something physicians and nurses are familiar, and these skills should also be respected since those also contribute a big portion in our health care system. Without epidemologists finding out the new breakout diseases, statisticians sorting out the newest data about certain deadly diseases, or health educators promoting health education, the society today wouldn't be the same if only have physicians existed. To me, every professions should be respect, therefore, physicians deserved te respect in term of health care but so as many other medical care professions.

Changing the High Status of Physicians

Our society places a higher value on human life compared to other species/things on that is planet. So when an individual sets him or herself apart and is redefined by what they do our views towards him or her are altered. For instance, if we do not have any underlying behavioral abnormalities (i.e. a desire to kill our neighbor) we consider life to be sacred, and respect those that have taken the time and oath to preserve human life. It is also no accident that in the United States this profession is so greatly revered. We can attribute its success to the American Medical Association (AMA). This organization set the guidelines/boundaries to be considered part of this profession. History also played its part giving preference to white rich males to be part of this exclusive profession at the time. Sure this might not be the case today, but many historical movements had to take place in order to incorporate minorities into this profession. I think the reason why nurses or other health care areas do not receive the same respect as physicians is because our society is still working on valuing every human equal to each other; and as the most basic example it starts with males and females.

Females are generally considered to be nurses in the health care field and they too have an organization that has been around since the AMA called the American Nurses Association (ANA) however, they do not receive the same respect as physicians because of the underling views of hierarchy that have longed been entwined in our society. Males have earned more money, worked, gone to school, and fought in wars much longer compared to females. I am sure just as in any profession; a male physician will receive more respect than a female physician a greater amount of time just because of societal views.

Physicians will always be well-regarded by society because of our societal value on human life. However, with time I am sure other professions can gain the same status as physicians but there is a lot of work that needs to be done to change the view and understanding of how each profession contributes to the overall well being, survival and advancement of human beings.

playing devil's advocate?

An MD commands a certain amount of respect

I believe that having an MD automatically commands a sense of place. An MD defines what everyone else has already said. It holds connotative values related to education, socio-economic status, dedication, commitment, and passion for health care. In some cases, MDs are very deserving of their status in society, but in other cases, the status that they hold only attracts the wrong physicians. This results in the problem that public health advocates face today; health disparities in all areas of life.

Why do they command such a high level of respect? Is it due to their training or their commitment to healing?

An MD can save a person’s life; something everyone values. That’s it. It’s not their education or their sense of commitment because even amongst MDs, there’s a hierarchy based on specialization.

Why isn't this respect given to nurses or physician assistants?

It’s all about power and an MD overpowers the nurse and/or a PA.

Or to teachers or public health professionals?

“Those who can, DO
Those who can’t, TEACH”
Unfortunately, this quote is famous throughout the nation. If only people realized that life can be affected in more ways than just physiology because “public health is everywhere” and we see that education is a large contributor to health status. Again, it’s society’s measure of power.

Is this high status deserved?
The commitment to what comes with and MD training is what deserves respect and admiration, but not by distorting the dedication of those professionals that are also advocates to the quality of life. There are quite a number of physicians that are definitely in the wrong field due to their lack of understanding of health disparities. I feel that they can be respected for their hard work during medical school, but I cannot hold them above other health advocates simply because they hold an MD.

The High Status of Physicians

In my opinion an MD gives people assurance that a person is highly qualified to be trusted with your life. Definitely physicians are given a high degree of respect that is sort of granted to them upon receipt of an MD, but in my opinion it is well deserved for their knowledge and extensive years of training. Respect can be earned through different modes such as attitude, deeds, accomplishments, skills, seniority, etc. In this case, those with an MD are granted respect for what we hope should be a legitimate qualification to have say in our health. Simply, I think physicians deserve respect for having the devotion to healing and saving lives. Usually it is hard to find people that you can trust without first knowing or interacting with them. Most people don't have the time these days to look for and build up respect and credibility for every service that they seek (computer repair, hair stylists, mechanical jobs, dental work, etc). Instead we either hear from word of mouth (references) or look for certifications that can give us some assurance that the a person is knowledgeable and can be trusted. I usually don't know my doctors from a personal point, but regardless, I follow the doctor's instructions and hope they are performing service upon my best interest. However, if we do feel that physicians are sort of commanding such undeserving high levels of respect, I must say that they're not the only people to be criticized. Very often respect is thrown around for people holding certain titles, having certain positions, attending or working for certain institutions. For example, very often, when people come to know that I am a graduate student at USC I automatically earn a respect that just a few seconds earlier was not necessarily present. It feels uncomfortable when other people mention their institutions but are not automatically given the same praise and enthusiasm as when they hear prestigious school names. Don't students, professors, and researchers from many less praised institutions perform outstanding work that should also be given merit? Having said this, while I believe physicians to an extent deserve the respect they command, I do also believe that other titles in the field of health are undervalued and under-recognized in their work and service.

Reframing the Question

The more I think about this and read into other people's posts, the more I'm convinced that the whole question of whether doctors "deserve" respect is moot. This may seem strange, since I'm one of the first people to have posted a response to this question, but I feel now that I've approached this topic in completely the wrong way.

There is no practical sense in trying to determine if physicians deserve respect; after all, there is no superhuman force looking on us from on high that bestows doctors with more respect than everyone else. Doctors are simply respected or not respected, or fall somewhere in between based on the aggregate opinion of millions of individuals, none of whom have the singular power to give physicians, as a population, a set reputation. As Jess posted, "respect commands itself," regardless of whether we want it to be commanded or not. Even if we could come to a consensus about the amount of respect physicians "really" deserve, there is nothing we can do to change their status in the real world, unless we were prepared to tamper with the personal perceptions and experiences of every American.

A more useful set of questions might be, "how much respect do doctors actually command?" and "why do they command a particular level of respect among particular populations?" That is, I think it would make more sense to try and determine the state of things as they actually are, instead of asking whether that state is "deserved" or not.

For instance, this blog uses the terms "high status" and "respect" interchangeably, but I would argue that the former does not imply the latter, especially in a society where authority is often challenged. Lawyers, for instance, are extremely well educated, but are viewed with a certain amount of mistrust and disdain in our culture. I would argue that physicians are, in more ways than one, becoming less and less respected by American society as a whole, and that whatever "high status" and power they once enjoyed are slowly being stripped away by Pharma, insurance companies, lobbyists, and even the patients' rights movement.

Now, whether this is morally right or wrong is one thing, but whether it helps our healthcare system is a whole other, probably much more important thing. Our arguments to stop or encourage this trend should not be based on moral entitlement (whether physicians "deserve" what is happening or not), but on an analysis of real efficiency and quality under one system versus another.

I am showing my earlier comment as a new post:
I think that MDs command respect because of what they had to go through to get into medical school.

First, if you look at the statistics for Keck School of Medicine Class of 2006, you can see what is required to be considered for admission:
Total Applications (2001) 4,407
Interviewed 451
Expected to Enroll 160
Mean GPA 3.62
Mean Total MCAT Score 32
Source: http://www.usc.edu/schools/medicine/school/about/facts_figures/index.html

Second, teachers or public health professionals are not usually given this respect because their training and education are not considered as rigorous as the training of medical doctors. To become a medical doctor it includes: getting an undergraduate/graduate degree, graduating medical school, passing all 3 steps of the United States Medical Licensing Examination, going through residency, and so forth.

Third and lastly, this high status and respect for doctors is deserved because of the education that they have to endure to become a doctor. However, all medical doctors are human and they are prone to mistakes just like everybody else. Hence, they should NOT be considered all-knowing and should be questioned and challenged by their patients.

Professional Independence and Responsibility

I think doctors should be graced with a high social status, more than any other health profession, because they are natural leaders and they tango with a line between with life and death. Blogger Catherine and I think alike in this way. Moreover, they have the power to make intelligent decisions for treatment and assign appropriate prescriptions that deliver cures to diseases. It is like they are our personal health lobbyer.
See it this way. A patient is like a project. Doctors lead the project and they can modify it how they see fit. When a patient comes in with an ailment, it is the doctor’s goal to cure him and everyone else is there to make contributions in some way. If they do, they must do it through the doctor: PhD professionals make important contributions to the R&D of medications but the doctors will ultimately write the prescription; Pharmacists prepare the medicine that the doctor wishes the patient to have; Nurses contribute to a patient’s well-being, on a daily basis, but then again, the nurses must follow conditions that the doctor places for the patient; Physician assistants practice medicine just like a doctor; they go to school for almost as long as medical doctors but they still must work under the doctor’s supervision. Doctors are the most independent and hold the highest responsibility to make us healthy again. For that, they deserve more respect form society.

The Respect of Necessity

The high status of any professional can be called into question, scrutinized and subsequently affirmed or denied as legitimate. Doctors, lawyers and heads of businesses are among those whose contributions to society are constantly being evaluated as worth the cost or unnecessarily expensive. We may be justified in wondering how so many CEO’s got to their positions when we see how many of them prospered with sheer luck and how so many others prospered without so much as a college education. One may state that they are better fit to run Company X than CEO John Doe, and they may be right. It is more difficult, though still possible, to question the inordinate sums of money that lawyers demand. We find many individuals who are willing to act as their own attorneys and are often times successful in their efforts. With businessmen and lawyers aside, we arrive at the MD. Among professionals, it is most difficult to question the legitimacy of a doctor’s knowledge and expertise not because of the initials after their name, but the inability for the common person to find a viable, and less expensive, substitute. It is this lack of alternatives that serves as the basis of our reverence of medical professionals.
Many are aware of the amount of schooling necessary to be a licensed doctor and prescribe medicine and treatment to their paying patrons. Educational integrity aside, the sheer number of years that doctors spend in school grants them a certain level of respect above professionals in other fields. I venture that beyond respect for a doctor’s educational prowess, people come to the hospital when their own methods have failed, and desperately looking for answers that they believe can only be solved with a doctor’s expertise. Having experienced and studied Pakistan's health system, I have witnessed the reverence that people immediately offer to the doctor sahib, or Doctor Sir. Patients arrive at the doctor’s office having exhausted all other options and turn to the one person who has the knowledge and experience necessary to fix their problem. It is no wonder that people, regardless of the country, become so exasperated when a doctor is unsure about what to do or has not seen their case before: the patient expects the doctor to have already dealt with the problem in their previous experiences or at least have the necessary literature to know exactly what to do. It is this hidden expectation that is ever-present underneath the outward show of respect.
Patients respect doctors because usually, the doctor is their last hope. There are of course other physicians that the patient can turn to, but in our current healthcare system, the patient is limited in his or her options. Unlike teachers who people unfortunately consider a dime a dozen, a doctor is given the responsibility of prolonging and bettering life for his or her patients. More than respect, schooling and even cost of care, it is the responsibility of caretaking that people place in doctors and doctors alone. For this reason, doctors are given respect equivalent to the amount of importance people place on a healthy life. The majority of the world’s population will continue to respect life and also, therefore, their doctor.

Joe thinks highly of Physicians because we all do.

The question posed is a very interesting one.  This same question could probably be asked for any other "top of society" degree like Ph.D., or DrPh, or PharmD, etc.  

What would the normal "Joe" think about a nutritional supplement endorsed through the ranks?  Let's start from the top.  If it is endorsed by an MD, Joe thinks, "Wow!~  These vitamins are endorsed by a doctor.  I may have never heard of this doctor, but still he is a doctor.  He has many years of schooling, he is far more intelligent and skilled than I am.  When I'm sick or feel like I might be dying, I go see my doctor to save me from my ills, and help me feel better.  He has the possibility of power over life and death.  Though, this MD is not my doctor that I know and trust, I still trust him because like all doctors, he is a savior, powerful, knows all, and I can trust him to endorse only what can be good for my health".

If the nutritional supplement is endorsed by a Registered Dietician, Joe thinks, "Oh cool!  These vitamins are endorsed by a dietician.  It's probably safe for me to take these since it will supplement my lifestyle and give me a boost in what I need.  My friend is a dietician, she knows all about nutrition and what the body needs in everyday meals.  She always stresses natural foods, but since this supplement is endorsed by a dietician too, must be ok and won't do weird things to me."

Next, we go to the third level in this minimally leveled illustration.  If the supplements are endorsed by nobody, Joe thinks, "The packaging on this bottle looks really cool but I wonder if I should buy it?  What if it does weird things to me and I shouldn't take it?  Maybe I should go ask my doctor...but I would have to go make an appointment just to ask him this?  I will probably forget, I wish someone could tell me whether this is a good product or not..someone credible!"

So long story short, MD's are as our society has built in general looked upon as "gods" so to speak.  They are the cures, the people who take away ailments, the ones who know all and understand all about the human body and how to save it from despair.  Ok, this might be an exaggerated statement, but in essence whether they, the MD is that great, altruistic, out for the good of mankind, and works many hours and has no personal life to save mankind from destruction, it doesn't matter...at first glance in this split-second fast paced changing world.  It is easy to believe.

High Status of Physicians

I believe that the high status of physicians is something that has developed since the very beginning of time.  The training and education that goes into becoming a physician is what gives this career its respect, credibility, and authority.  In addition to the time devoted to learning the material to medically help people, I believe that (in general) physicians are so highly regarded because they are healing people, saving lives, and ideally improving the quality of life of their patients. I mean, when you think about it, general practitioners must go through at least 4 years of undergraduate work, 4 years of medical school, and 2 years of residency; coming to a total of 10 years of school on top of high school and elementary school.  That is 10 years of schooling on top of basic schooling.  Not to mention that learning never really ends because there are always new procedures and technologies being developed.  

In regards to other health professionals not having as much respect and authority in society, they are truly undervalued.  The hospital setting, nurses, occupational therapists, nutritionists, technicians, etc are really the people who help and nurse the patient back to health.  The physicians are with the patients for maybe 20 min. max/a day, while nurses and other health professionals are with the patients around the clock. Public health professionals also do not gain enough respect from the public either.  Public health professionals really collect so much data that physicians use to help run their practices and public health research will ultimately effect the medical world.  Hopefully this will change with the higher demand for other health professionals.

I think the way we view physicians has been a perspective that has been passed on from generation to generation.  Whether this perspective has been reinforce with the amount of education, income, ability to effect lives, etc, physicians are still people who maintain a high status in society.  

Respect commands itself and it can neither be given nor withheld when it is due. -Eldridge Cleaver

As someone who aspires to become a physician someday, I may have what some of you might consider a biased and incredibly naive perspective on this topic of discussion, so here I go with more than a little trepidation....

What makes us respect certain people? It's a combination of attributes, namely, if that person has a lot of knowledge or expertise in any given field, if he has power or is in a position of power, if he is emotionally mature due to having successfully overcome difficulties in life and career, if he is committed to others, and if he has a lot of money. And who are people that we respect? Professional athletes, firefighters, policemen, teachers, Nobel Prize winners, scholars, humanitarians, philanthropists, astronauts, the President...we can all think of someone we respect who possesses at least one of those attributes.

But physicians enjoy the luxury of possessing not just one or two, but every single one of those characteristics, in addition to something that in my opinion cements their place at the top of the societal food chain: trust. Whether genuinely or just out of necessity, people trust physicians to take care of their aches and pains. In more severe circumstances, they trust physicians to keep them alive. They trust physicians to be confidential with their personal information. Because of the weight of responsibility that they carry, it seems only natural that physicians be held in high regard. On the downside, this leads them to be perceived as being infallible. Here's an excerpt from Body of Work which I think explains this phenomenon nicely:

"Here in medicine, because failure and weakness can cost people their lives, it is unacceptable to fail; it is unacceptable to be weak. Admission of either makes one seem unfit for the lofty charge....Doctors stay up thirty-six hours at a time and subsist on vending machine fare. They perform emergency surgery while others sleep. They maintain composure when the baby is lodged wrong in the birth canal, when the bone breaks through the skin, when the face is unrecognizably burned away. Part of this comes from necessity. But the problem arises when instead of setting aside our natural reactions, they are denied altogether. Then the culture simply becomes superhuman." (Montross)

(Digression: For anyone interested in going into medicine, or just interested in human anatomy in general, Body of Work by Dr. Christine Montross is an amazing book on the "meditations of mortality.")

I think in that sense, it's easy to forget that doctors are also regular people. They're not always model citizens, much less superhuman. They can be greedy and arrogant. But that doesn't necessarily cancel out the fact that they are good at their jobs, that arrogance can be born out of experience, or that their intentions are not in the right place.

For example, Dr. Bernard Kouchner (a fascinating person, in my opinion), is a French gastroenterologist who has been widely criticized as being a blunt, abrasive, opinionated, quick-tempered man. The Economist has described him as being "hard to work with...vain and media-obsessed." And yet, Dr. Kouchner has a resumé many can only dream of attaining. He is one of the core founders of Médecins Sans Frontières (better known in English-speaking territories as Doctors Without Borders), and Médecins du Monde (Doctors of the World). He is an outspoken advocate of humanitarian intervention, and has thrice served as the French Minister of Health. He may not win any congeniality prizes, but he has demonstrated incredible compassion for others, and--face it--he gets things done. With that being said, even an arrogant physician will still command a lot of respect.

(Despite his level of expertise, would you willingly seek an arrogant doctor out for help? Maybe not. Which brings us to the debate of Good Doctor versus Bad Doctor, but that's a whole 'nother can of worms.)

Back to the trust thing, why are physicians trusted more than other healthcare professionals? Take nurses, for example. A patient might tell the nurse that he has a headache, but then confide in the doctor that he actually came in to see about the rash on his butt. Why is that? (I don't really have an answer, though personally I am very fond of nurses and think that they definitely deserve a lot more appreciation and recognition.) Something unique to physicians is that they are able to forge strong relationships with their patients, even though they may not see each other very frequently. That one time you went in to get stitches? Hey! It was a bonding experience. Your doctor got to know you. He got to know your family. He helped you, showed that he was on your side, and in doing so, became part of your team. Sure, you're not going to hang out with your doctor on a regular basis, but the next time something happens to you, there's a strong feeling of dependability--you'll go back to see him again. And that is a relationship that's rarely forged with any other professional. The nurse who took your vitals in the morning will not be the same nurse who takes your vitals in the evening. The doctor who took care of my aunt when she had breast cancer remained with us for more than ten years.

What about dentists? Here, again, I confess to be biased (being the daughter of a dentist and all). On the whole, they're not hated, exactly. Feared is more like it. I blame the strange, scary noises the dental instruments make. As a result, though you rely heavily on your dentist to take care of your teeth, you'll never trust him 100%. Have you ever gone to the dentist's office, heard someone moaning/screaming/crying/praying in the depths and immediately wanted to run as far away as possible? Something evil's got to be going on in there. Dentists = sadists. Is it any wonder, then, why we tend to wait until all our teeth corrode and implode before we (grudgingly) call to make an appointment?

So, then, physicians seem to be unopposed in their position at the top of the professional hierarchy. Is that position deserved?

I cannot say that they don't deserve to be respected. I can list off the top of my head a few physicians I'd like to throw down the stairs, but I can name just as many (more, even) who I admire and emulate. Nor can I say that physicians are the only ones who deserve to be highly respected. But instead of lobbying for equal respect for all professionals, it is more pragmatic to utilize physicians' current social position to enact more positive and progressive changes in the quality and efficacy of healthcare services being delivered. Instead of remaining an independent entity, physicians ought to be more aware of their role in the healthcare system overall. They need to realize, or be trained to realize, that because they are trusted leaders among laymen, they are not just healthcare providers but communicators as well. In this way, medicine can evolve from a two-dimensional field into something more all-encompassing.

Are physicians > everybody else?

Let's take a minute to think about doctors.  What comes to mind?  That person who charged you too much for a test that seemed simple?  Maybe, it's someone who tried everything to save someone you love from cancer.  Or helped your friend who just broke her leg roller-skating?  Or delivered a baby (and so participated in the miracle of life).  Perhaps you've gone to the same family doctor your whole life, and your doctor is someone you consider part of your life.

My point is, that if you take a step back and look at the role of doctors in the lives of people all throughout history, you will probably see that they have ALWAYS been highly esteemed.  It is true that there is a certain stigma associated with physicians in the US in these times - they get paid too much, they are arrogant, they don't take enough time out to really care.  But, I challenge anyone who says those things to walk down the street of your average town or city in the US and find someone else who has the knowledge and ability to help your loved one who has cancer, or your friend who broke her leg.

I'm not saying we should consider doctors the best thing that ever happened to us, because as we all can probably agree on to an extent, the healthcare system is flawed and many physicians have succumbed to the monetary pressures of the insurance companies and the private entities which they work for.  I am saying that before we go criticizing doctors for those things alone, they should be given praise for entering such a challenging field, and actually having some answers to the tough questions.  It goes back as far as history does, that doctors were the only people in the community who could help with certain ailments.  Even in communities where a medicine-man without the "formal" training we associate with medical school cures the communities sicknesses, the medical person is elevated in the eyes of the people.

While physicians aren't by any means supernatural (and shouldn't have to carry that burden), in some people's eyes, they are the closest thing to God on the earth.  Is there anyone else who could open up someone's skull and perform brain surgery?  Successfully?!  I didn't think so.  I don't think it is just the American way to put them on a pedestal - I really believe they have been there as long as the profession has been around, and will remain there forever.

The High Status of Physicians

Considering the logistics of all that it entails to become a physician in this country, I believe that the respect that is typically afforded to them is deserved. Their training is by far the most rigorous and lengthy and the requirements just to even be admitted to medical school and successfully graduate are such that only those who have proven themselves capable are granted the title of M.D. I feel that it is safe to assume that every doctor has entered this profession understanding the responsibilities that will ultimately be in their hands. They realize that their direct actions and decisions can be the difference between life and death and having the courage to pursue such a profession is admirable. Often times these physicians have to trust their own judgment, make split second decisions, and essentially go with what their intuitions and gut feelings are telling them to do with respect to their patients lives, which is something that I think takes a great deal of confidence. Not everybody can be as confident with their own decisions.

Having said all of this, I also do believe that other professionals such as physician assistants, nurses, LVNs, CNAs, teachers, public health professionals, etc. are not given nearly the amount of credit that their hard work has earned. Without them, doctors would not be able to practice in the manner that they do since the healthcare system works best if all of its components are working as a team. A patient's successful health outcome is not due solely to the doctors actions, but also to the nurses, PAs, CNAs, and LVNs that carry out whatever the doctor has ordered. But ultimately, the healthcare "team" needs a captain- someone who acts as the leader to delegate responsibilities and duties to the rest of the team as well as designing a course of action tailored to each individual patient's needs. And it seems only fitting that those who have the most educational experience in the field are given the title of "captain."

Physician Status

It goes without saying that physicians do command a certain amount of respect throughout the healthcare community and society as a whole. The reason behind this, however, is not so clear. I think it is easy to say that years of higher education and difficult clinical rotations, long hours, and dealing with potentially traumatic cases "earn" them the respect and regard that they hold (and I feel that it does, to a certain degree), however there is also the notion that society has always held doctors in a high regard because they are a necessary part of our communities. Of course, when a position such as that of a physician becomes "indispensable" it can be difficult for the members of the profession to maintain perspective and not get lost in the amount of control and power they hold in the workplace. We can see ideas like this illustrated in everyday life (e.g. "the doctor knows best"), which further promote the mentality that a physician should always have the final say in a case.

It is interesting (and unfortunate) that other healthcare professionals and teachers do not always receive the same amount of respect and credibility in the work place, even though they are often the ones who deal with patients on a more personal level. Again, the notions of years of training and decision-making status come into play, and society has a set attitude in regards to how it perceives various professions and the levels of prestige associated with them. Unfortunately, many professionals are not always given the amount of respect and prestige they deserve.

Physician Status

In our culture the first people that come to mind in times of physical distress are doctors.  We rely on them to save our lives in terms of immediate care or following our long term health needs.  In the past before the discovery of antibiotics and the subsequent knowledge of how to administer those drugs, a simple infection could be fatal.  As technology improved and the medical field continued to evolve, the possibilities of survival improved substantially.  These days we expect that doctors can fix almost any physical ailment or disease presented to them, and for the most part, our technology today allows them to treat a plethora of illnesses.  Since doctors have this relatively new power to extend life or alleviate symptoms they have taken on an almost god like reverence.  The average patient won't stop to think about the years of research or the thousands of other people who contributed to the current state of the medical field, rather they will purely see that their doctor has cured them.  For this reason, amongst the other valid points previously mentioned, I believe doctors are held in such high regards.  

Physicians and Future Health Care System

Generally speaking, like Howard and Jean said, I agree that Physicians deserve the high status in the community and command high level of authority, on the ground of their commitment and devotion to become good MDs. Sometimes, they also need to make critical and creative thinking during pivotal times; especially during the procedures in order to come up with good outcome of their patients.

On the other hand, however, I also do believe that there are rooms for improvement in current health care system. It also needs to be fixed or changed for better health care deliveries to the general public.

In order to do so, I think we need concerted efforts from all other health care professions like nurses, pharmacists, public health professionals, physician assistants as well as government officials, politicians, and insurers etc. In the future, there should be empowerment of authority to other health care professionals like public health professionals, nurses and pharmacists etc because they also deserve the level of respect and status like MDs are getting right now.

The High Status of Physicians

Physicians are given so much respect because of the years of training and education they received. They also have much more hands on experience when it comes to health issues. Although nurses and other healthcare professionals work equally as hard, they are unfortunately less respected, perhaps because of fewer years in school. However, everyone knows that without the help of nurses/P.A.s etc., a hospital or a clinic would not run as smoothly. Nurses, for example, see patients a lot more often than doctors. They usually get to know the patient better and build a relationship with them. Doctors who truly care about their patients deserve a high degree of recognition but other health professional should receive the same respect.

Too Much Faith, Too Much Respect

In my not so respected opinion,  MDs are held in far too high esteem in the United States. It is as if their education and years of slaving over text books and lab experiments automatically grants them high merits and respect from others.  All too often, I've noticed a general lack of humility from numerous doctors, who maintain a heir of arrogance, not just in their approach to health, but in their dealings with others. 

I agree with mary anne that their is a certain hierarchy that exists with Drs at the top of the "food chain."  Nurses, public health officials, and others who do the nitty gritty on a daily basis are clearly overlooked and not given their due respect. 

The thought process that the longer the schooling, the more respect one deserves, is fundamentally flawed.  Respect should not be blindly handed out, but instead granted to those who truly achieve great things in their life, and also choose to live with dignity and treat ALL others, regardless of the lettered addendum to their last night name, equally.  

Physician Status and the Healthcare System

Oops; reposting comment as a new post:

I agree with Howard that physicians command (and deserve) a high level of respect simply because of the nature of their education, in the same way that PhDs and JDs command more respect than a BA or BS. Competition tends to favor those that are best at what they do, and there are are few (if any) professions more competitive than medicine, with med school admissions rates hovering in the single-digit percentages. I'm sure everyone's heard of the abuse of residents in clerkship programs and the rigor of specialty fellowships, so there's no need to preach to the choir. 

That said, a good medical student will not necessarily make a good doctor. Medicine is a conglomeration of many fields, some of them disparate (counseling and biophysics, for instance), and it's hard to imagine that any academic institution (however rigorous, selective, or well-funded) could cover all the bases. Similarly, the traits that make the best doctors, such as empathy or grace under pressure, are not qualities that can really be "taught," but must be gained through real experience with real patients and real emergencies; that is, they're acquired after the fact.

I think doctors command respect not (necessarily) because they had a rigorous education, but because the healthcare system has granted them exclusive powers and privileges that do not extend to any other type of health practitioner. I believe these powers are derived from two different (but related) sources. 

The first is the medical community. Clinical medicine is highly hierarchical in nature, with physicians at the top. After all, doctors--not nurses, physician assistants, paramedics, technicians, or anyone else--are legally responsible for the life of their patients. In a hospital, you can hardly blow your nose without getting a doctor's signature, and when treatments or procedures are not properly executed, the doctor is the first to be held accountable. This does not mean that doctors are entitled to carry this burden or that they all carry it well. The title "physician" commands respect not because all physicians have been outstanding medical leaders, but because leadership is something that comes with the job itself. 

The second source of a doctor's unique powers are his patients. I think there is something truly astonishing about the doctor-patient relationship--that someone would voluntarily entrust a complete stranger with his life, and then (as if that wasn't harrowing enough) fork over an absurd amount of money to have this person pump him full of strange chemicals, slice him open, or tell him what to eat or drink on a daily basis, based on nothing more than faith in the stranger's job title.  This is not like the relationship between you and your fireman, in which you either let him do his job or watch your house burn down on the spot. Any rational human being could tell you that a burning house needs to be put out, but only a doctor can tell you that 1) you have an invasive colorectal carcinoma; and 2) it can only be treated by topoisomerase inhibitors. Right. The only way you could confirm is to either see more doctors or become one yourself. 

It is also not like the relationship between you and your teacher, in which failing to follow your teacher's recommendations will not lead to a slow and painful death. 

The doctor-patient relationship is also not a case of paternalism or "the doctor is always right" as the cartoon above suggests. Doctors cannot legally force (or coerce) their patients to do anything. When a patient meets their cardiothoracic surgeon for the first time and says, "Sure thing, go right ahead and stop my heart and bring me back from the dead," it reflects the patient's voluntary consent, not the surgeon's mandate. 

My point here is that it is the nature of the healthcare system that gives physicians such a high standing, and not necessarily anything the physicians themselves have done. The system makes it so that doctors have no choice but to sign off the orders of nurses, assistants, and technicians, have no choice but to become responsible for a patient's life, and have no choice but to accept the powers that patients grant them (except under the "right to conscience" executive order, which I will vehemently ignore for the moment). Medical students are not necessarily those members of society most capable of shouldering these difficult responsibilities; in fact, I would wager that most premeds have a romanticized (or overly academic) view of medicine. The responsibilities are simply thrust upon them as soon as they get a passing grade on their Boards.

It is the job, and not the person, that commands respect, and it is the healthcare system that describes that job. I think that if you changed the system such that the job description changes, physicians as a population would lose their high standing, regardless of the rigor of their education or training. However, I feel that there is nothing wrong with the job itself; after all, someone has to do it. And since we are all prone to human error, I think the public needs to accept that some medical mistakes and inefficiencies are inevitable. However, I believe there are others that can be avoided, if only by changing the way that doctors are selected and trained, or how their interaction with their patients and peers is regulated. 

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