In 1955, the iconic movie of the day, Rebel Without A Cause, starring James Dean and Natalie Wood, was released by Warner Brothers, and immediately it became a box office hit. The story was one of defiant teenagers and their struggles with the social chaos of high school. It was clear from the opening scenes that the parents of these highly impressionable young people seemed either unable or unwilling to love and guide their children through these troubled times, and the results were predictably disastrous.
The moral of this classic story is implied by the title, there is nothing wrong with a rebellious spirit, provided it is properly directed and serves a higher purpose. There must be a cause to be defended, or a wrong to be righted. The rebel must have an overarching goal or all that expended energy serves no real purpose. The same can be said today regarding the outrage, anger and frustration being displayed by many of America’s physicians in response to what is obviously a systematic assault on the independent practice of medicine. But, unlike teenagers, doctors cannot expect parental guidance. Even if it were offered by the sages among us, our collective inability to agree on much of anything would render such advice just another topic for contentious debate.
There is one thing upon which we all should be in agreement, and that is how incredibly hard we worked to achieve the once lofty status of physician. The right of passage through medical school and residency is an arduous one, and throughout modern history it has been accompanied by respect from virtually all quarters; that is, until recently. Doctors today are seen more as interchangeable parts in a massive health care machine, run by a convoluted system of payers. If one health care provider, (i.e.) physician, fails to do the bidding of the machine operators, they are simply replaced by someone who is more compliant, more manageable or more employable.
Naturally, many physicians are unhappy with this public downgrade and are looking for ways to fight back; to rebel against the injustice of a system that demeans their humanitarian achievements in favor of profit and power. Thus far the rebel fight has had little impact, and is yet to be joined by sufficient numbers to alter the actions of those massive bureaucracies that control the finances, and thereby make the rules.
Physician rebels need a cause to unite us, something to provide direction for our counterattack. Something upon which everyone can agree. Something we all have in common, whether a new primary care resident or a seasoned neurosurgeon; a radiologist reading films remotely from home or the ER doc in the pit that ordered them at 3AM. The one thing that we all share is our profession, and it is that profession that has come under siege from all directions. We are being marginalized, and it’s time for every physician to recognize that what we do is not just a job. Our talents and intellect have been purposefully channeled through years of individual hard work and sacrifice, and each of us has justifiably obtain the title medical doctor. No one can take that away; not a hospital administrator, not an insurance executive, not a government bureaucrat, not even a specialty board, unless we allow them to do so.
We are sworn as physicians, not only to our patients, but also to each other, as brothers and sisters cut from the same cloth. It is my opinion that all physicians have a moral obligation to themselves and their colleagues, past, present and future, to protect and defend our profession from anyone who would seek to control, dominate, subjugate or enslave any of us. Our professional ethics, which have stood the test of time for two and a half millennia, must not be subjected to outside interpretation or arbitrary revision. They belong to us, and it is up to us to protect and defend them.
I have often heard the question asked by colleagues in doctors lounges, “Who is going to take care of us in our hour of need?” There can only be one acceptable answer – a physician. The next group of American doctors will be inspired by the same calling that has drawn countless generations of compassionate individuals into this profession, but only if we successfully defend that profession today. Now is the time for us to stand together, united as physicians, men and women willing to fight against the myriad forces of control, offering our collective efforts as true Rebels With A Cause.