What is the Value I Bring as a Clinician?

What is the value that I bring as a clinician?

As clinicians, I think we do not ask ourselves this question enough and do not encourage our trainees to consider the question either. However, I think it is a good idea to keep this question in mind with all the demands and stressors that we encounter every day as clinicians. We can easily lose perspective on why we are valuable.

We apparently have some value because someone pays us a good salary, we carry a lot of responsibility, and we have a lot of training under our proverbial belts.

So what is the value that we bring into the patient encounter?

The most obvious effect is the medical knowledge. Clinicians graduate school with a lot of medical knowledge, and graduate residency with even more. However, medical knowledge changes as the field of medicine advances through research. What is cutting edge treatment today can be obsolete in 10 years or less.

Having the knowledge itself is only one part of our value. How we handle knowledge is arguably as important as the knowledge itself. In light of the field advancing, another skill clinicians learn is how to look for new knowledge. Our medical culture ingrains both formal and informal continuing education in most clinicians. This can range from going to a major conference to checking an old hospital algorithm for updates. From learning and evaluating the medical knowledge, clinicians become pretty good at differentiating legitimate medical knowledge from bogus medical knowledge. Finally we learn how to use the medical knowledge, how to apply it effectively in a real patient with all their complications and comorbidities.

Knowledge by itself is inert. Knowledge by itself is a tool lying unused on a shelf. A person must have certain skills to handle that tool properly. In the hands of someone that doesn’t know how to use it, the knowledge can be dangerous. Everyone with internet access can acquire medical knowledge. But it takes training and experience to find the knowledge efficiently, to know to question if the knowledge you find is legitimate, and to know how to apply it.

A patient may come to a clinician demanding a treatment that they read about online. Many clinicians have even had a patient tell them something to the effect of, “I don’t want to question your medical knowledge, but I think the treatment I read about on the internet would be better than what you recommend”. Typically this proverbial patient only comes with that bit of knowledge, not a greater context of how to properly handle medical knowledge. The patient may think the clinician’s only value is in the knowledge itself. The patient lacks the deeper understanding that, the ability to properly handle that knowledge is an equally powerful part of our value as clinicians.

So the next time someone tries to question what your value is as a clinician because they have found a bit of medical knowledge themselves or if for another reason you question what your value is as a clinician, remember that your value lies in not only your knowledge, but your ability to handle medical knowledge by reliably updating your knowledge, differentiating if the knowledge is legitimate, and knowing how to use the knowledge. These are important lessons for all clinicians to keep in mind regardless of their level of experience.

For those of you interested in learning more about the processes behind how we use medical knowledge in a clinical setting and a structure for teaching this to students and residents, please check out my book: A Guide to Clinical Decision Making