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Letter: Professional Exceptionalism

doi: 10.1097/01.EEM.0000398970.55021.ef


“I believe in American exceptionalism. Just as I suspect the Brits believe in British exceptionalism and the Greeks believe in Greek exceptionalism.” — President Barack Obama

“Medicine is what I do. It's not who I am.” — A recent emergency medicine residency graduate

Every generation of physicians is different, shaped by both the changes in medicine and in the society around them. My generation trained with minimal technology — no CT or MRI scans, no computers, no ultrasound — relying primarily on our clinical acumen and bedside skills, as limited as these were. Society granted us an exalted position imbued with inherent respect, however. And, on the whole, most felt we deserved this because what we did was special, and we worked hard to get there. The present generation's roots are not the same. Weaned on computers from the crib, surrounded by a medical technology that is expanding exponentially, they rely less on hands-on and more on sophisticated diagnostic modalities to give the correct answer.

But an unappreciative society views them differently. Most patients have seen the flawed characters on “ER” and “Grey's Anatomy,” and while they will grant that doctors are skilled professionals, so is the pilot who landed the plane safely in the Hudson River: well-trained and skillful, perhaps, but not really all that special and certainly not sacrosanct.

I believe the resident's quote above reflects this change. In fact, I might argue that you could change the profession, and the quote would be equally applicable to a waiter, a pilot, a postal worker — whether Greek, British, or American. Maybe my generation threw themselves too much into medicine, sacrificing family and personal time, but I believed in professional exceptionalism, the feeling of doing something unique — almost sacred — and working hard to deserve the honor.

I believed I had a wonderful gift, and was able to do and experience things few others could. I could save lives, heal the sick, and relieve suffering. I helped people die with dignity and peace. I cried with the parents of a baby taken by SIDS. I stroked the head of a young man paralyzed in an accident. I celebrated with my staff when a heart started beating again. It saddens me to think that some in the new generation of doctors feel there is a touch of the ordinary in what they do. I never felt I was on a pedestal, but I never felt common either. If you see medicine as just “something you do,” you run the risk of seeing yourself as just another employee with scrubs and a stethoscope.

Robert T. Fitzgerald, MD

Nuevo Gorgona, Panama

Dr. Fitzgerald blogs at The Truth About Med-icine (

© 2011 Lippincott Williams & Wilkins, Inc.