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After the Match

After the Match

Who Do You Trust?

Cook, Thomas MD

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doi: 10.1097/01.EEM.0000488830.85455.63

    The currency of human society is trust, and society could not exist without it. Even money is essentially trust. Possession of a piece of paper currency only has value if you trust the government to honor what is printed on it. You cannot even drive a car unless you trust the person coming from the other direction to stay on his side. Imagine the trust your patients have when they come to see you. They allow you to touch them anywhere on their body, stick them with needles, give them chemicals to swallow, instill fluids and even more chemicals into their veins, and even cut them open. That level of trust is amazing. If anyone else in society does this, we throw them in jail and condemn them on the evening news.

    Imagine you are conducting a survey of Americans, and ask this question: “How would you rate the honesty and ethical standards of people in different professions?”

    How do you think doctors would do? You might be surprised to find that we do pretty well. Year after year, doctors are in the top five. In fact, they are usually second. Who is number one? It's the person next to you at work, your nurses. In the annual Gallup poll asking Americans this question, nurses consistently are said to be the most trustworthy of all professions. In fact, they pretty much blow away everyone else. Rounding out the top five are usually teachers, pharmacists, and police officers. (Gallup, 2015;

    Who do you think is at the bottom? This is predictable. Lawyers, bankers, stockbrokers, used car salesmen, telemarketers, politicians, and lobbyists rank the lowest in trustworthiness. Even the profession charged with keeping an eye on these scoundrels, journalism, is only a little better.

    Even with all of medicine's problems — astronomical cost, questionable quality, and overwhelming prescription drug abuse — the general public thinks medicine is an honorable profession. There is just no substitute for creating goodwill than by being kind while relieving suffering and pain.

    Financial Expertise

    But as you continue in your career, you will run up against a problem. You must intimately interact with members of many of the least trustworthy professions. You can always hang up the phone on telemarketers, and you can walk away from pushy salespeople. But lawyers? You cannot get away from them. Your future will include numerous interactions with attorneys when you buy houses, negotiate contracts, and get sued.

    You also cannot avoid bankers and finance professionals. You will make too much money, and short of stuffing it under your mattress, you will have to find some of them to trust. They will help you set up retirement plans, purchase insurance, secure mortgages, set up family trusts, and consider investments. Some would argue that you could do a lot of this yourself. But consider how much time you would have to invest to learn how to do this. And what if you make the wrong bets? Now you have wasted time and money. But how do you find the right people to trust? Handing over hard-earned money to someone else to manage is difficult to do. What if they lose it? What if they steal it? What is the secret to finding someone who will be good for you?

    Fortunately, the answer is simpler than you think. You have the best database for local financial expertise possible: your attendings. They have traveled the path you will take in the future. It is usually common knowledge which of your faculty members are financially savvy, and most of your attendings will utilize the same bank, mortgage broker, and investment planner because they have received great service in the past.

    And, remember, you are a great catch. Financial professionals want you as a client. Your income potential is large, so leverage their desire to work with you. Set up meetings with financial professionals your faculty recommend. What do you have to lose? You do not have anything now. You are up to your eyeballs in debt. What can they steal or lose?

    Losing half your savings now is a pittance relative to losing half of it 20 years from now. Talking to them costs you nothing but time, and it will give you experience in how they interact with their clients. Yes, I know residents want to have fun when they are off duty, but you must look at this as part of your training. Learning how to have these conversations will only improve through practice and comparison.

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