What's the most challenging part of being a doctor? Talk to 10 doctors and you will get a dozen opinions on that question. You can imagine the many typical answers -- long hours, tough problems, years of schooling, residency training, too much memorization and many, many more. With such a long list of challenges, why and how does anyone become a doctor?

First, you become a doctor because it is exciting to solve often difficult problems that concern other people. You might work on a macro scale -- caring for populations as a public health doctor or making discoveries that impact thousands of patients as a research doctor. On the other hand, as is more often the case, you might work on a micro scale -- becoming a clinical doctor and taking care of one patient at a time. But whichever kind of “doc” you become, there is always one challenge: keeping up with what is new -- or, as we say in the biz, lifelong learning.

I had a friend in college whose father was a doctor (turns out he was an ENT like me). She told me that he got up at 5:30 a.m. every morning to read his journals. I didn’t believe it. Now I do. (BTW, I get up to exercise and save my reading for later, usually in chunks on less busy days.)

After more than 25 years in the field, I still find in my reading something new and interesting and applicable to what I do every day. It takes effort, energy, and discipline. Not only are there scientific journals to read, but the internet offers endless sources of information and mis-information for our (and our patients') consumption. Today, patients are likely to come to you with a lot of information they have learned online. Sometimes it's relevant, sometimes it is not. But it’s there to be dealt with, answered, and considered with an open mind.

We say that doctors “practice” medicine because it is always possible to become a better physician. Good doctors don't just keep up with the latest medical discoveries, but also keep up their excitement and enthusiasm for applying newly acquired knowledge to the patients for whom they care. Every patient teaches you something, and if you keep an open mind, patients will teach you as much as any book or article.

And that’s the next hard challenge—keeping an open mind. Every patient really is different. Medical knowledge is derived from groups of patients who are similar, so we can “control” for the variables of disease and make some sense of a new treatment or how a disease behaves. Sound good? Sound scientific? It is, but it may not be the best way to care for the individual patient. And that is a whole other discussion.

Stay tuned for an upcoming post about the competing interests of the individual patient and society. Dana, what is your take on this one?

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